Government minister: We don’t have the money for HIV-preventing PrEP drugs

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A government minister has claimed there is not enough money to fund HIV-preventing drugs, despite no official cost-effectiveness analysis having taken place and experts projecting it would save money in the long term.

Pre-Exposure Prophylaxis (PrEP) drug Truvada can reduce people’s chances of being infected with HIV by up to 99 percent if taken daily – and is available in a number of countries to at-risk groups including sex workers, gay men, and people in serodiscordant relationships.

Health experts say rolling out PrEP in the UK would be cost-effective if it leads to even a small reduction in HIV infections, as the lifetime cost of just one HIV infection can be up to £380,000.

NHS England had claimed earlier this year that it was not responsible for commissioning PrEP, suggesting it is up to local councils – but a court battle last month concluded that the NHS does have responsibility.

But in a debate on the issue, health minister Lord Prior of Brampton claimed there was “no money” to fund the drugs, even though they are far cheaper than treating HIV infections for a lifetime.

The former Tory MP claimed: “In a sense we face the same problems dealing with hepatitis C as we do with PrEP and countless other drugs: there is a limit to the money we have available. There is a cost.

“The noble Lord says that it will all end up with the taxpayer, but the fact is that the taxpayer has given us a certain amount of money for the NHS. We would like to spend a lot of it on treating hepatitis C, on PrEP and on other drugs, but we simply do not always have the money to spend as we would like.

“We would like to spend a lot of it on treating hepatitis C, on PrEP and on other drugs, but we simply do not always have the money to spend as we would like.”

A review of PrEP by drug cost watchdog NICE is due to be published shortly.

The only current projection of the cost of the drugs, undertaken by Public Health England, found that even in the worst case scenario – with low uptake and no decrease in drug costs – investment in PrEP would eventually break even.

However, the drug costs are set to decrease drastically when patents expire in 2018, with generic PrEP drugs costing just £40 a month.

Others in the chamber took on the claims that PreP is expensive.

Lord Black of Brentwood, who called the debate, said: “[The] argument, of course, is money, and it is estimated that it could cost up to £20 million each year to provide. However, that figure is dwarfed by the existing cost of HIV to the NHS.

“The lifetime cost of treating someone with HIV is now in the region of £380,000. As people live longer, that figure will only increase.

“It is Mickey Mouse economics to refuse to fund effective prevention measures for those most at risk at the cost of just £400 a month—a sum soon likely significantly to reduce—when you set that against the huge cost of treating someone who contracts HIV.

“If PrEP prevented just a handful of infections each year, it would easily be saving money for the NHS and the taxpayer.”

His comments were echoed by Lib Dem peer Lord Scriven.

He said: “If PrEP were widely available to high-risk groups, particularly men who have sex with men, it could prevent 7,400 cases by 2020.

“The noble Lord, Lord Black of Brentwood, made it very clear that the lifetime cost of treating somebody with HIV is up to £380,000; the cost of PrEP is £400 a month.

“That is the equivalent of 83 years’ worth of PrEP to treat one person living with HIV. The economics are not questionable in terms of the costs of PrEP.”

Cross-bench peer Lord Patel concurred that PrEP would save money in the long term.