Moving to Australia with Inflammatory Bowel Disease
Taking the leap of faith to move to the other side of the world can be nerve-racking for anyone, let alone someone with a chronic illness! Like most young people in Ireland at the moment, I started to feel the pull to emigrate after seeing endless amounts of Instagram posts of people living in what appeared to be in paradise down under! Hot sunny days, golden sandy beaches, a relaxed lifestyle, well-paying jobs, a thriving community of warm and welcoming Irish people, what’s not to love! As I started getting more and more excited about the idea of moving to Australia, I was met with an equally mounting feeling of fear and dread as the question of “Can I even move?” started to rise.
My number one concern was how I would be able to access and afford my medication, because, as we all know, biological drugs are very expensive if not subsidised. Through some research, I was delighted to discover that there is a Reciprocal Healthcare Agreement between Ireland and Australia. This means that Irish citizens are granted subsidised access to approved medications under the Pharmaceutical Benefits Scheme (PBS), a similar system to the Drug Payment Scheme in Ireland. This scheme subsidises common medications used to treat Inflammatory Bowel Disease, including oral immunosuppressants, anti-inflammatory medications, injections, and infusions. You can find the list of approved medications on the Australian Pharmaceutical Benefits Scheme website (https://www.pbs.gov.au/browse/medicine-listing).
Next on the list was to get set up with a gastroenterologist in Australia. This will be personal for everyone depending on whether your specialist has any connections in Australia, but I carried out my own independent search for a consultant. A page I found really useful was the IBD Passport website which recommends IBD centres in the area you are travelling too (https://www.ibdpassport.com/).
Living with IBD for 19 years, I was really searching for a consultant who was involved in research and was constantly keeping an eye out for new innovative treatments! These consultants normally work out of University Hospitals, so this helped to narrow down the search. I will say, it is much easier to organise healthcare when you are physically present in the country, and, after not hearing much back from consultants I decided to jet off to the land down under armed with a referral letter from my gastroenterologist, my international insurance policy, and a supply of 3 months medication to buy me some time – (Note: 3 months’ supply of medication is the maximum amount you are allowed to bring into Australia). If you are struggling to get in touch with a consultant in Australia, I would really recommend visiting a local GP and obtaining a separate referral letter and gastroenterologist recommendation. Like Ireland, the waiting time in the public hospitals can be a few months so getting referred to a consultant who also works out of private rooms can really speed up the process!
After visiting a GP in Australia, I had an appointment with my new consultant in as little as two weeks. At this appointment, I was surprised to realise that my medication Filgotinib was not available in Australia, which is why I really recommend checking on the PBS system before moving over! Thankfully, there was a similar medication called Rinvoq which had recently passed clinical trials but was not yet approved on the PBS system. Nevertheless, thanks to my cover under the Reciprocal Healthcare Agreement, my consultant had the opportunity to nominate me for participation in a Patient Familiarisation Program. This initiative, facilitated by pharmaceutical companies, is designed to familiarise prescribers with the medication, while providing patients with accelerated access to the drug. Three days later, the pharmaceutical company initiated a monthly delivery to my door free of cost until the drugs approval onto the PBS! Following the drugs approval, I now collect my medication at my local pharmacy at a subsidised rate by showing my Irish passport to the pharmacist (Yay for reciprocal healthcare!!!).
Now the money you save on medication will be put to good use if you are not eligible for Medicare, that is the Australian medical benefits scheme which covers everything from GP visits to blood tests and scans. This will most likely be the case if you are entering Australia on a Working Holiday Visa and are from the Republic of Ireland.
The biggest expense I have encountered are blood tests, with my most expensive one costing $800 (€477), so this is definitely something to keep in mind if you require regular blood tests for monitoring your medication. Additionally, GP visits can cost anywhere from $90-$280 (€54-€168) and consultant fees are typically $180-$350 (€107-€209). However, hospital inpatient care that is medically necessary is covered under the Reciprocal Healthcare Agreement. Having ended up in A&E with complications from perianal Crohn’s disease, this is something I have experience with.
Dealing with a flare up abroad can feel really isolating, especially without the support of your family and having your home comforts, but I was delighted to be greeted by a lovely Irish A&E doctor who brought back a little bit of home!
I will say that although you might not have your family with you to support you through those tough times, the Irish community here in Australia is absolutely incredible. Being so far away from home, everyone really looks out for each other. No matter what the situation, there is always floods of support from people you might have only just recently met! I have also found that getting out of my comfort zone and taking full responsibility for my health has brought about a newfound confidence!
It is not easy to leave your support circle behind and start afresh, but my gosh the moments where you are watching a sunrise on the beach with your new friends, seeing a kangaroo in the wild, waking up to beautifully sunny days, traveling to magnificent places, makes it oh so worth it.
Christine McCaffrey (@the.bright.sideee)
Crohn's & Colitis Ireland has partnered with Crohn's & Colitis Australia to offer support when an IBD patient is moving to Australia. If you require support, call us on our helpline 01 531 2983 or drop us an email to firstname.lastname@example.org