NHS England confirms decision not to fund drug that helps prevent HIV

By The Press Association1st June 2016News EnglandMedication / Vaccines, News England, NHS, Sexual Health

NHS England has stood firm on its decision not to fund a preventative treatment for HIV.

A row erupted earlier this year after the body said it would not routinely fund pre-exposure prophylaxis (PrEP), a drug described as a “game changer” by HIV charities.

PrEP helps prevent infection in people without HIV who are at substantial risk of getting it.

The pill – brand name Truvada – contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV.

When someone is exposed to HIV, these medicines can work to keep the virus from establishing a permanent infection.

When taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by more than 90%.

In March, NHS England decided the treatment was a preventative service and was therefore not its responsibility. It has said local councils are in charge of funding preventative health services.

But NHS England agreed to a re-evaluation after the National AIDS Trust launched a legal challenge.

However, on Tuesday, a statement said it had “considered and accepted NHS England’s external legal advice that it does not have the legal power to commission PrEP

“As set out in the Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) Regulations 2013, local authorities are the responsible commissioner for HIV prevention services.”

It said if it prioritised PrEP, there was the risk of a legal challenge from proponents of other “treatments and interventions that could be displaced by PrEP”.

Ian Green, chief executive of Terrence Higgins Trust, said the decision was “shameful”.

He added: “This country used to lead the way in the fight against the HIV epidemic, but today, our National Health Service has washed its hands of one of the most stunning breakthroughs we’ve seen; a pill which, if taken correctly, is almost 100% effective in preventing HIV. A pill which is already available in America, Canada, France, Kenya and soon to be Australia.

“How did it come to this? It defies belief that, after 18 months of false hope, delays and U-turns in the battle to see PrEP made available on the NHS to people at high risk of HIV, today we are in a worse position than when we started.

“It is a mess, and the people who will feel the effects are the 2,500 men who have sex with men who will be needlessly infected with HIV each year in the UK. This figure has not changed in a decade. Who will claim responsibility for the lifelong impact this will have on people’s lives?

“It’s not right that people who know themselves to be at high risk of HIV have to buy PrEP themselves from the internet at considerable personal expense. Many high-risk people are living in poverty and they simply cannot afford to protect themselves against HIV.”

An NHS England spokesman said: “We have listened carefully to stakeholders, and will continue to work with Public Health England and other partners on reducing HIV transmissions, but our external legal advice is clear that NHS England does not have the legal power to commission PrEP.”

A spokesman for the Local Government Association said: “This is hugely disappointing and a missed opportunity to launch a ground-breaking method of treatment which could halt the spread of HIV and potentially save lives.

“Councils have invested millions in providing sexual health services since taking over responsibility for public health three years ago, and the PrEP treatment could help reduce levels of HIV in the community.

“During the transition period to the implementation of the NHS and Care Act 2010, NHS England sought to retain commissioning of HIV therapeutics, which the PrEP treatment clearly falls into.

“It is, and should remain, an NHS responsibility unless it is fully funded for local authorities to pass on.

“Councils are already having to manage significant funding reductions to their public health budgets of £500 million over five years and NHS England’s decision not to commission PrEP will only heap more pressure on public health services.”