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Readers Panel: Should the NHS fund preventive drugs such as PrEP?

Following a successful court challenge brought by the National AIDS Trust, the High Court has told NHS England it can fund the HIV prevention drug PrEP. NHS England, which is appealing the ruling, claim that as a preventive treatment the drug should be funded by local authorities. Nursing Standard readers panelists have their say. 

 

Following a succesful court challenge brought by the National AIDS Trust, the High Court has told NHS England it can fund the HIV prevention drug PrEP. NHS England, which is appealing the ruling, claim that as a preventive treatment the drug should be funded by local authorities. Nursing Standard readers panelists have their say.


Drew Payne (@drew_london) is a community nurse in north London
Drew Payne
Drew Payne


Research shows that PrEP is an effective drug for preventing HIV. It could save the NHS millions and keep thousands of people healthy. If PrEP prevented heart disease or diabetes, I’m sure NHS England would jump on it. But it prevents HIV, which still carries stigma. HIV damages health, and managing it is lifelong and expensive – far more expensive than PrEP. What this shows is the level of crisis of government funding, but while the funding debate rages on, lives are left in limbo.


Linda Drake is a practice nurse in south London
Linda Drake
Linda Drake

The NHS cannot afford every medication or treatment which may benefit the population, and difficult decisions about prioritisation have to be made.
Local authorities are now responsible for commissioning HIV prevention services, yet they face even worse budget cuts than the NHS.

Every new treatment has opportunity costs. If PrEP is funded, treatments for other conditions, such as those for children with cystic fibrosis, may not be. To avoid a postcode lottery, a fair and transparent process must be in place to show how these challenging resource allocation decisions are made.


Grant Byrne (@GGByrne) is a nursing student in Scotland
Grant Byrne
Grant Byrne

Now that there is legal clarity, the NHS should cough up for PrEP. Were this another patient group or illness, I doubt we would be seeing the same hesitation to roll out a drug with a proven 86% prevention rate. PrEP won’t come cheap, but next to the cost of treating HIV, the savings are significant.

HIV still carries a heavy burden of stigma and destroys lives, and current methods of health promotion simply aren’t working. PrEP can stop the spread of this damaging illness. So what is the NHS waiting for?


Rachel Kent is a mental health nurse at Camden and Islington NHS Foundation Trust, London
Rachel Kent
Rachel Kent

Funding a drug to prevent HIV transmission will not prevent transmission of sexually transmitted diseases, such as gonorrhoea and chlamydia. Although PrEP has been shown to be 86% effective, condoms are 98% effective as well as being significantly cheaper and protect against all STDs when used correctly.

However, I think there is a case to be made for people in committed relationships where one partner is HIV positive and the other is not. Protecting the non-infected partner would be a reasonable and responsible application for a preventative drug such as this.

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