Since April 2023, people living with HIV who are visiting Australia on medium- and long-term visas as well as people who are looking to stay permanently in Australia and ineligible for Medicare or other reciprocal health arrangements can access their anti-retroviral (ARV) medication for free like other people living with HIV in Australia.
Positive Life NSW has long advocated for a change in the way HIV medication is accessed in Australia by people who don’t have Medicare and this new agreement is a welcome addition to the availability of anti-retroviral (ARV) treatment options.
What happened previously?
If you were ineligible for Medicare in Australia there was a system called compassionate access which was administered by the pharmaceutical companies ViiV Healthcare and Gilead, who make most HIV medications worldwide. People living with HIV who didn’t have access to Medicare were able to get compassionate HIV medication provided for free by these pharmaceutical companies. This system has been replaced.
What is the new funding agreement?
The new scheme is called the Medicare Ineligible Scheme. This federal funding agreement provides up to $12.5m per year to states and territories to provide HIV medication to people living with HIV who are ineligible for Medicare. The scheme will run until 2026, however we expect this agreement to continue beyond 2026.
This funding agreement does not cover the use of HIV medication as pre-exposure prophylaxis (PrEP) because there are other options available to access PrEP. If you want to know more about PrEP, please call Positive Life NSW on (02) 8357 8386 (freecall 1800 245 677) or email contact@positivelife.org.au
What does this mean for me?
In April 2023, the NSW Government agreed to implement the Medicare Ineligible Scheme with the Australian Government.
If you are ineligible for Medicare and currently get your HIV medication through compassionate access, your s100 prescribing doctor will have a conversation with you about the new scheme. Not much will change, and you’ll still be able to access the same medication you have previously taken.
This can also be a good time to review your HIV medication with your doctor and discuss what other ARV medications are available for you. As people living with HIV ourselves, Positive Life NSW promotes ‘patient-centred’ decision making and choice; there are a wide variety of HIV medications available in Australia. If your current medication isn’t working for you, you can always discuss your options for changing your HIV medications with your doctor.
To get your HIV medication through the Medicare Ineligible Scheme, you’ll need to get your HIV medication from a NSW hospital pharmacy or a NSW sexual health clinic that’s associated with a hospital pharmacy. The good news is that you’ll be able to take more than a month’s supply home with you, depending on which clinic you visit.
NSW Sexual Health Clinics are free, and many are attached, or close by, to a hospital pharmacy. If this change is inconvenient and you want some support to work out how to get your HIV medicines, call Positive Life NSW on (02) 8357 8386 or 1800 245 677 (freecall).
