NHS abandons roll-out of HIV-preventing PrEP drugs

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The NHS has abandoned the roll-out of HIV-preventing PrEP drugs in the UK – despite the drugs growing in popularity in other countries.

Pre-Exposure Prophylaxis (PrEP) drug Truvada can drastically reduce people’s chances of being infected with HIV by up to 99 percent, if taken daily.

The drug has been endorsed by the World Health Organisation and is already routinely available to at-risk men in a number of countries, including the United States, Canada, France and Israel.

In the UK, a two-year study found the drug was greatly effective at reducing the risk of HIV transmission, with authorities expected to conclude that the drug should be rolled out to men who have sex with men on the NHS.

However, in a shock U-turn, NHS England kicked the issue into the long grass today – by ordering a further two-year study at “early implementer test sites”, restricting the drug to a very limited number of test cases rather than rolling it out nationally.

The decision has infuriated HIV groups, who have warned that it puts people at risk of HIV transmission and puts the UK well behind other countries.

Deborah Gold, Chief executive of National AIDS Trust, said: “NAT shares the anger and distress felt by many thousands of people across the country at NHS England’s decision to abandon its work to provide PrEP, near the very end of the process.

“In a shocking U-turn, NHS England has pulled the plug on over 18 months of hard work which demonstrated the need, efficacy and cost-effectiveness of PrEP.

“Instead of a long-term policy to give PrEP to all who need it, there will be £2 million over two years for 500 gay men ‘most at risk’.

“The decision is not informed by any due process; the amount of money is arbitrary; the claim that more ‘testing’ of PrEP is needed is disingenuous.

“500 does not remotely cover the number of gay men at high risk of HIV nor meet the needs of heterosexuals at risk.

“There is no clarity within the Department of Health, the NHS or Public Health England as to who long-term is responsible to commission and fund PrEP. ”

NAT added: “This is simple maladministration with serious consequences.  Over 5,000 gay men will get HIV over the next two years – very many of whom would not have done so if PrEP had been delivered as proposed.”

NHS England said: “NHS England is keen to build on the excellent work to date and will be making available up to £2m over the next two years to run a number of early implementer test sites.

“These will be undertaken in conjunction with Public Health England and will seek to answer the remaining questions around how PrEP could be commissioned in the most cost effective and integrated way to reduce HIV and sexually transmitted infections in those at highest risk.
NHS abandons roll-out of HIV-preventing PrEP drugs
“These test sites will aim to provide protection to an additional 500 men at high risk of HIV infection as well as inform future arrangements for the commissioning and provision of this innovative intervention.

“In addition, NHS England is keen to explore how a period of further support can be offered to the participants enrolled in the PROUD study and is committed to making funding available where there is a clinical need for additional help.

“NHS England and Public Health England will launch a process to seek expressions of interest for the test sites from local authority areas with a view to confirming successful applications by June 2016.

“These will run over the next two years and will aim to test the ‘real life’ cost effectiveness and affordability of PrEP as part of an integrated HIV and STI prevention service.

“The DH and partners will consider the relevant findings from the test sites to inform respective commissioning responsibilities for HIV care and treatment and HIV prevention.”