HIV treatment costs put in the spotlight

THE Alfred hospital’s quashed plan to introduce a co-payment scheme for HIV medications last year has prompted an upcoming community forum held by Living Positive Victoria on the cost of HIV treatment in Victoria.

It will also coincide with the release of a report commissioned along with the Victorian AIDS Council/Gay Men’s Health Centre (VAC/GMHC) from the Burnett Institute, focusing on reducing financial barriers to HIV treatment.

Living Positive Victoria’s President Ian Muchamore told the Star Observer he hoped the forum would help establish a community response to these issues to take to the Victorian Government and relevant health bodies.

“That’s what next week is about—it’s about having an open discussion about what our position as a community should be, informed by the best evidence that we can find,” Muchamore said.

Last August, a discovery the Alfred hospital was planning to introduce co-payments for HIV medications led to community outcry, and Victorian Health Minister David Davis stepped in to ensure free distribution would continue.

A spokesperson for the minister told the Star Observer this week the health department was in discussion with the Alfred and the Melbourne Sexual Health Clinic (MSHC) regarding co-payments.

The situation last year revealed the precarious, ad hoc nature of the arrangement between the Alfred and MSHC, which distributes the free HIV medications.

“Yes, there are a large number of people that receive what most people would call ‘free medications’, they don’t pay a co-payment to Melbourne Sexual Health Centre, but even glancing through that report you can see it’s not everybody,” said Muchamore.

“There’s been an assumption that everyone in Victoria has access to free meds. People have spoken in that language quite a lot, and one of the hopes that I have is that the forum will help challenge that.”

Access to HIV treatment in Victoria is highly concentrated in Melbourne, with few locations outside the city’s metropolitan area able to dispense medications. Further, the arrangement at MSHC is unique within the state, requiring people living with HIV across Victoria to travel to the centre in Carlton to access free medications.

These access issues present further financial barriers for people living with HIV in regional and rural Victoria.

Living in Mount Beauty in the Victorian Alps in the state’s North-East, Cath Smith has been fighting to gain better access to HIV medications on a number of fronts, and faces significant financial barriers due to where she lives.

“In order to get a script written and dispensed, I was travelling down to Melbourne Sexual Health Centre. That would involved an approximately 800 kilometre return trip, and I would stay down there because in total it’s about eight to nine hours driving,” Smith told the Star Observer.

Smith would try to maximise her visit to Melbourne by seeing a number of specialists for her HIV, but each trip down remained an expensive proposition, around $300 per trip just in petrol and one night’s accommodation.

Through a series of specific arrangements with her GP, pathologist and specialists, Smith has been able to avoid regular lengthy and expensive trips to Melbourne, but said government policy reform is vital to ensure other people living with HIV in regional Victoria don’t have to go through everything she had to in order to access medication cheaply.

She argued the key to better access was reform of the Victorian Patient Transport Assistance Scheme, which currently does not recognise those authorised to dispense HIV medication as ‘specialists’, rendering HIV treatments ineligible for reimbursement under the scheme.

“It’s a barrier to accessing treatment for people, but you look at the bottom line—we’re only talking about a handful of people here. You want them on treatment so they’re not going to cost the hospital system later on because they got on to treatment later, or possibly inadvertently infected someone else,” Smith said.

Smith is currently awaiting the outcome of a review of the scheme, which she hopes will address some of these issues.