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Scotland first country in UK to fund PrEP through NHS

Watchdog approves HIV prevention drug as cost-effective

Adrian O'Dowd

Tuesday, 11 April 2017

People at risk of contracting HIV in Scotland will be able to access the HIV prevention drug PrEP (Pre Exposure Prophylaxis) by the NHS – a first in the UK.

The Scottish Medicines Consortium (SMC) has announced that PrEP has been deemed a cost-effective treatment to prevent the transmission of HIV and will be made available on the NHS in Scotland.

The SMC said Emtricitabine/tenofovir disoproxil (Truvada) was accepted to help prevent sexually transmitted HIV-1 infection in adults who were at high risk of being infected.

Dr Alan MacDonald, chairman of the SMC, announcing the decision alongside other drug approvals, said: “I am pleased we were able to accept these new medicines for routine use in NHS Scotland.

“Emtricitabine/tenofovir disproxil PrEP, when used together with safer sex practices may help to reduce the spread of HIV, which is an ongoing priority for the Scottish Government.”

Charities welcomed the decision, saying that multiple studies had proven that PrEP worked in preventing new HIV infections.

The PrEP4Scotland Coalition (HIV Scotland, Terrence Higgins Trust Scotland, Waverley Care, and National AIDS Trust [NAT]) said in a joint statement: “We applaud the SMC for taking this bold step to tackling HIV in Scotland.

“PrEP provides opportunities to reinvigorate how people at higher risk of HIV exposure engage with testing and prevention opportunities, and it is a vital opportunity to make a real reduction in the number of new HIV transmissions.”

Robert McKay, national director for Terence Higgins Trust Scotland, said: “We are delighted that people at risk of HIV in Scotland will finally have access to this groundbreaking pill that will protect them from HIV.

“This makes Scotland the first country in the UK to routinely commission PrEP on the NHS. It can now be used as a vital tool in our HIV prevention armoury – alongside condom use, regular testing and early treatment - to help bring an end to HIV transmission in Scotland.

“Not only will this make a life-changing difference to each of these individuals by protecting them from a lifelong and stigmatised condition, but for every person who would have become HIV positive without PrEP, NHS Scotland will save £360,000 in lifetime treatment costs.

“But there’s a long way to go before everyone at risk in the UK has access to PrEP. NHS Wales makes its decision on PrEP later this month, and we hope they will follow Scotland’s leadership in preventing HIV. Meanwhile a long-awaited PrEP trial from NHS England and Public Health England is still yet to materialise.”

George Valiotis, chief executive of HIV Scotland said: “In 2016, HIV Scotland published a PrEP good practice guide, and administered Scotland’s expert group which produced prescribing criteria, cost assessments, and mapped information and training needs of workers and the community.”

In November of last year, the Court of Appeal upheld a High Court decision that the NHS in England had the power to fund PrEP drugs, despite NHS England’s argument that local authorities should fund the drugs because they were responsible for preventative health.

In December, NHS England announced plans for a large scale clinical trial of the drug that will involve around 10,000 participants over three years.

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