NHS England launches trial of PrEP HIV treatment after court ruling

Sexual health campaigners have welcomed a major trial of HIV prevention medication for 10,000 people at risk of the condition.

NHS England has announced it was launching the pilot of PrEP (pre-exposure prophylaxis) after losing a legal battle over who should fund it. 

The drug, described as a ‘game changer’ in the fight against HIV and AIDS, has been shown to reduce the risk of infection in people who are at high risk by more than 90%.

The £10million, three-year clinical trial is due to take place in early 2017-18, NHS England said. 

Details needed

Ian Green, chief executive of sexual health charity, the Terrence Higgins Trust, said the PrEP pilot was a positive move in the fight against HIV. But he also called for more details on how it would work, how people would access the drug and long-term plans for PrEP.

‘With 17 new HIV diagnoses made every day, we need to be bold and ambitious in our approach to HIV prevention – and this must include access to PrEP for all who need it,’ he said.

‘Preventing the spread of HIV is good news for everyone. Not only will this make a life-changing difference to each of these individuals by protecting them from an incurable and highly-stigmatised condition, but for every person who would have become HIV positive without PrEP, the NHS will save £360,000 in lifetime treatment costs.’
 
Last month, the Court of Appeal upheld a High Court ruling which said NHS England did have the power to fund the drug, despite its pleas that the responsibility lies with local authorities.

Cost benefit 

NHS England said that although the evidence around the clinical effectiveness of PrEP was ‘strong’, Public Health England (PHE) had highlighted potential issues with its roll-out.
 
‘These questions will be answered by the clinical trial, paving the way for full roll-out’, NHS England said. 

Pharmaceutical companies have worked with the organisation on ‘lower and more responsible prices’, NHS England said.
 
NHS England has also agreed to fund 10 new specialised treatments, but it said three treatments will not be funded due to poor cost benefit. This includes second stem cell transplants for patients whose disease has worsened.

‘Epidemic’

PHE is working in partnership with NHS England to coordinate the large trial.

 PHE director of health and wellbeing Kevin Fenton said: ‘Currently 13,500 people are living in the UK with undiagnosed HIV, and we are still seeing around 5,000 new infections each year.

‘Given we are in the fourth decade of this epidemic, there are too many new infections occurring, and we need to use all tools available to save lives and money.’

In other news 

• Sex, PrEP and the moral backlash
• Appeal court ruling on HIV drug victory for common sense, says leading nurse
• Nurses urged to lobby NHS England over drug that can prevent HIV transmission