PrEP (Pre-exposure Prophylaxis)
An estimated 103,700 people are living with HIV in the UK and I sympathise profoundly with anyone who has been affected. I believe it is vital that more is done to improve early detection, prevention, treatment and care and I appreciate that organisations such as the Terrence Higgins Trust and Prepster have been campaigning for PrEP drugs to be made available on the NHS as a preventative measure against HIV.
NHS England set up an expert group to consider whether PrEP should be managed on the NHS and last year a study carried out in 12 NHS trusts showed that the drug Truvada cut infections among men who have sex with men by 86%. I appreciate that this evidence is encouraging and that PrEP could make a difference.
It was widely expected that NHS England might consult on PrEP, but NHS England stated in March 2016 that it holds no responsibility to commission HIV prevention services and that local authorities are instead the responsible commissioner for HIV prevention services. NHS England confirmed that it would provide £2 million over the next two years to run early implementer test sites for 500 men most at risk.
I know that organisations such as the Local Government Association raised concerns about this decision and the impact it would have on local authority budgets. I am also aware that groups such as the Terrence Higgins Trust were disappointed that NHS England decided not to consult on PrEP. However, in April 2016, NHS England confirmed that it will reconsider its position on the commissioning of PrEP and its decision to remove PrEP from the specialised commissioning annual prioritisation process. This process, which is being overseen by NHS England’s Specialised Services Commissioning Committee, is expected to be completed by the end of May 2016. I await NHS England’s final decision and will follow this closely.
In the meantime, the Government says planning will continue on the early implementer tests sites. The Government has also stated that whatever the commissioning arrangements for PrEP, decisions on its funding will depend on the full assessment of its clinical and cost effectiveness, its affordability and how it can be integrated with other HIV prevention efforts.
More widely, I am concerned that Government cuts to public health budgets over the coming years could put the future of HIV prevention services at risk. I believe there needs to be long-term investment in the NHS’s future.
There is still a long way to go to prevent the spread of HIV and to treat and support those living with it. I hope, therefore, that NHS England will fully consider the evidence and that the Government will listen and respond to the concerns that have been raised about access to PrEP.
Published 13 January 2017