How to access HIV antiretroviral treatment and care in Australia

How can I access HIV treatments in Australia at low cost?

In Australia, drugs that are considered to be necessary or life saving are subsidised by the government under the Pharmaceutical Benefits Scheme [1][Pharmaceutical Benefits Scheme] The federal government program which subsidises medication costs in Australia. Anti-HIV drugs are part of a special part of the PBS called Section 100 (S100) which is used for expensive, highly specialised drugs. (PBS).

A medicine may cost hundreds of dollars but patients prescribed it under the PBS pay much less.

HIV antiretroviral [2]A medication or other substance which is active against retroviruses such as HIV. drugs are included in the scheme under Section 100 (s100) of the Highly Specialised Drugs Program. Unlike other PBS drugs, these ‘specialised’ drugs can only be dispensed through hospital-based pharmacies and can only be prescribed by appropriately qualified medical practitioners.

Do I qualify for PBS medicines (including HIV treatments)?

Yes – if you hold or are entitled to a Medicare card.

Medicare card holders are able to access the PBS as well as obtaining other benefits including free or subsidised clinical [3]Pertaining to or founded on observation and treatment of participants, as distinguished from theoretical or basic science. care.

People who are Australian citizens or permanent residents, New Zealand citizens resident in Australia, people on Temporary Protection Visas and some people who have applied for permanent residence are entitled to a Medicare card.

Asylum seekers who have applied for permanent residence and have permission to work are usually eligible for Medicare, however Medicare eligibility for asylum seeks can vary. Some state health departments waive fees for hospital treatment and other medical services for asylum seekers who are Medicare ineligible, however this may not extend to providing antiretroviral medication.

• Further information about Medicare eligibility and how to apply for a Medicare card [4]  

Yes – if you are covered under a Reciprocal Health Care Agreement between Australia and your country of residence.

Eligible visitors from countries with Reciprocal Health Care Agreements (RHCA) can also access the PBS. Australia currently has RHCAs with Belgium, Finland, Italy, Malta, the Netherlands, New Zealand, Norway, the United Kingdom, and Sweden.

These agreements make medically necessary health care available to citizens of these countries in Australia, and to Australians travelling in these countries.

RHCAs only allow restricted access to health care services including the PBS. Depending on your country of origin and the type of visa you have will determine the amount of access you have to subsidised treatment in Australia, and the length of time you can access the PBS.

• Further information about RHCAs, to see if you qualify, and for information about how to enrol in Medicare [5] 

No – if neither of the above applies to you.

Unfortunately, there are many people legally living in Australia who do not qualify for access to the PBS. Many overseas students fall into this category; as do many people who are here on working visas; and the partners of Australian residents who are waiting for a decision to be made about their own permanent residency.

If you do not qualify for the PBS but need access to HIV antiretroviral drugs, there are a couple of options [6] open to you.

Neither of these options is ideal. NAPWA is continuing to lobby for the rights of all people with HIV in Australia to have subsidised access to antiretroviral drugs.

• Information about options for obtaining HIV treatments if you aren’t entitled to Medicare [6]  

NAPWA believes all people should be able to access HIV treatment, regardless of their citizenship or residency status. More information about NAPWA’s efforts to secure access to HIV treatments for people who aren’t eligible for Medicare [7].