Home delivery of anti-HIV drugs

Key points

  • Your HIV clinic may offer home delivery of your HIV drugs as an alternative to collecting them from the hospital pharmacy.
  • There are practical benefits for both patients and health services.
  • You can continue to collect your drugs from the hospital if you prefer.

In some situations, people on HIV treatment in the UK have the option of having their anti-HIV drugs delivered to a place of their choice.

Many clinics offer ‘home’ or 'local' delivery, an optional alternative to collecting your anti-HIV medication from the hospital pharmacy as part of your regular clinic visits. The service is free of charge to patients.

You may be asked to consider this service. If you are eligible (see below) and you feel comfortable with it, you can sign up. You should always have the choice of continuing – or going back – to collecting your drugs from the pharmacy at your HIV clinic.

Benefits of home delivery

There are practical benefits for both patients and health services, such as a reduction in pharmacy waiting times.

There is also a significant financial benefit to the National Health Service. Drugs delivered to patients in the community are not subject to VAT, whereas VAT is paid on those dispensed on hospital premises. HIV services, like all public sector services, are under significant financial pressure and increasing the take-up of home delivery services offers the chance to make savings without having to reduce frontline services. NHS England expects all HIV outpatient services to offer people who are eligible for home delivery the chance to take it up. But it is recognised that the service will not suit everyone and healthcare teams will take that into account.

How does home delivery work?

Your clinic will have a contract with one or more delivery companies – they generally offer a range of healthcare services. Each has a registered pharmacy, operating in accordance with the Medicines Act 1968 (which governs the supply of medicine) and the Data Protection Act 1998. Staff are required to meet high professional standards, including maintaining confidentiality. Clinics set standards and monitor quality.

You will need to provide delivery information and decide whether you want anyone to be able to sign for and receive a delivery on your behalf (a ‘designated signatory’). You will also sign a consent form, confirming you understand the service and how your personal information will be treated. 

You will be given information about delivery, including:

  • a clinic phone number for queries about medication or your health
  • a delivery company number; contact them to change or query your delivery arrangements.

You can have your drugs delivered to your home, someone else’s home (such as a family member or friend), your workplace, a post office or postal depot of your choice.

In some cases, drugs can be delivered to a local pharmacy (which one may depend on the company) and you collect them at a time that suits you. You will need to show appropriate ID. Some companies will deliver your drugs to another UK address if you are away from home temporarily.

Glossary

undetectable viral load

A level of viral load that is too low to be picked up by the particular viral load test being used or below an agreed threshold (such as 50 copies/ml or 200 copies/ml). An undetectable viral load is the first goal of antiretroviral therapy.

regimen

A combination of medications and the way it is taken.

consent

A patient’s agreement to take a test or a treatment. In medical ethics, an adult who has mental capacity always has the right to refuse. 

viral load

Measurement of the amount of virus in a blood sample, reported as number of HIV RNA copies per milliliter of blood plasma. The VL is an important indicator of HIV progression and of how well treatment is working. 

 

range

The spread of values, from the smallest to the largest. The inter-quartile range (IQR) only includes the middle 50% of values and measures the degree of spread of the most common values.

Your drugs will be delivered by:

  • Royal Mail postal service or
  • courier delivery. The delivery company will contact you to arrange a delivery time (you can usually choose a time slot for a specified day, Monday to Saturday, including weekday evenings). You will need to use van delivery for drugs that are liquid or need to be refrigerated. The drivers carry photo ID and do not know what is in the package.

Both types of delivery need to be signed for. You may also be asked for a password that you will have been given by the company. The package should not be given to someone who is not a designated signatory. There will be no information about what the package contains on the outer wrapping.

When you switch to home delivery, your prescription will be passed on to the home delivery company for your next supply of your HIV treatment. You may also be given a separate prescription for an interim supply if you don’t have enough to last until then.

The delivery company will contact you to arrange a delivery time and method. If you have arranged a delivery and no designated signatory is there to receive it, it will be returned to the delivery company depot or sorting office, and a card left for you asking you to collect it or rearrange the delivery. If you miss several deliveries, your clinic may want to discuss whether home delivery is the best option for you. Your clinic will still have to pay the cost of the failed deliveries. 

If you are taking other medication, you may be able to have that delivered at the same time. The pharmacy at your clinic will be able to tell you if this is possible. Unlicensed drugs, controlled drugs, drugs not on the home delivery ‘agreed list’, drugs prescribed by your GP and drugs you receive as part of a clinical trial are not included in this scheme. You will need to collect these from your usual supplier.

"Many people living with HIV use home delivery and find it convenient and efficient."

The rest of your HIV care will stay the same. You will attend your clinic for routine monitoring, and give your next prescription (for the next three to six months’ supply of HIV treatment) to the hospital pharmacy, where it will be checked and passed on to the home delivery company. You can use this opportunity to discuss any medication queries or concerns.

Who is eligible for home delivery?

To be able to take part in a home delivery scheme, you will usually have to:

  • have been stable on HIV treatment for at least six months, with an undetectable viral load for the last six months; on the same treatment regimen for three to six months; with stable regular health monitoring results (such as liver function tests); and without any other condition that might affect your HIV treatment
  • be able to attend regular clinic appointments and have a good attendance record
  • provide a home, work or other postal address where the drugs can be delivered safely and securely
  • provide a contact number and/or an email address for messages.

If you are eligible and interested, speak to a member of your healthcare team or the HIV pharmacist at your clinic. You will need to have talked to your HIV doctor and pharmacist before registering.

If at any stage you need to change your treatment regimen for some reason, you will need to go back to collecting your drugs from the hospital pharmacy. You can rejoin the scheme once you are stable on your new treatment.

Things to think about when considering home delivery

Many people living with HIV use home delivery and find it convenient and efficient. It reduces the time your regular clinic appointments take as you don’t have to wait for your drugs to be dispensed by the pharmacy. You don’t have to carry bulky packages of drugs with you when you leave your appointment. HIV clinics believe offering the service increases patient choice.

On the other hand, home delivery can reduce opportunities to discuss your treatment with a pharmacist. It is probably not suitable if you have adherence problems or are experiencing severe side-effects. You need to have an address where deliveries can be made safely, meeting a level of confidentiality you are comfortable with. It may not be suitable for people living in shared housing who have concerns about confidentiality, for example, unless there is an alternative address that would work.

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