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Potential eligibility criteria for HIV prevention drugs outlined

NHS England proposes intermittent regimens for high risk MSM and trans men and women

Ingrid Torjesen

Friday, 12 August 2016

NHS England has launched a 45-day public consultation on a proposed clinical commissioning policy proposition on pre-exposure prophylaxis (PrEP) for HIV.

The consultation comes just a week after a High Court judge ruled that NHS England does have the power to commission PrEP.  

In June, NHS England said that it would not be commissioning PrEP on external legal advice that “it does not have the legal power to commission PrEP” as local authorities are the responsible commissioner for HIV prevention services. The National Aids Trust (NAT) charity then applied for a judicial review.

On 2 August, a High Court judge ruled that both NHS England and local authorities have the power to commission PrEP. NHS England has been granted permission to appeal the decision. NHS England has emphasised that the consultation on its proposed commissioning strategy is being run “without prejudice” to the outcome of that appeal.

The consultation proposes that tenofovir disoproxil fumarate (TDF)/emtricitabine will be prescribed as an intermittent regimen for men who have sex with men, trans women and trans men, clinically assessed as being at high risk of HIV acquisition, unless, based on clinical assessment, a daily regimen is indicated, in which case this will need to be fully documented. A daily regimen will be prescribed for heterosexuals clinically assessed as being at high risk of HIV acquisition.

“The evidence review supports the use of either intermittent or daily dosing in high risk MSM,” the document says. “No trial evidence is available to support intermittent dosing in high risk heterosexuals.”

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