NHS chiefs have approved a highly effective treatment in the prevention of HIV transmission in Scotland, making it the first country in the UK to do so.
Pre-Exposure Prophylaxis (or PrEP for short) is now approved by the Scottish Medicines Consortium (SMC), the body who consider drugs for use on the NHS, and it will now be down to each of Scotland’s Health Boards to decide whether they will allow GPs and clinicians to prescribe the drug.
In a long-awaited statement on the SMC website today, the news was confirmed:
“Emtricitabine / tenofovir disoproxil (Truvada) was accepted to help prevent sexually transmitted HIV-1 infection in adults who are at high risk of being infected (‘pre-exposure prophylaxis’ [PrEP]). Emtricitabine / tenofovir disoproxil given as PrEP is one aspect of an HIV-prevention strategy and should be used in combination with safer sex practices such as using condoms. Patient groups highlighted that current prevention methods have not managed to reduce the spread of HIV in Scotland over the last ten years. “
A number of agencies in Scotland have been campaigning for PrEP to be available since the success of trials from 2015 were known. In a joint statement from Terrence Higgins Trust Scotland, National AIDS Trust, HIV Scotland and Waverley Care, they welcomed today’s announcement:
“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. All NHS Boards in Scotland need to now follow the SMC’s advice and ensure they’re making PrEP available to those who need it, so that no-one at risk is left behind.”
The drug, called Truvada, will be targeted at those with the highest risk factors for exposure to HIV, including men-who-have-sex-with-men (MSM). The preventative treatment involves an HIV-negative person taking drugs on a daily basis, often only one pill.
In the past 12 months the NHS in England kicked the issue of PrEP into the ‘long grass’ with a further 2 years of trials before a similar decision would be taken whether or not to approve the drugs for use by clinicians there. Nicola Sturgeon, however, said she thought Scotland “would take its own path” on the decision, back in April 2016, when speaking to Pink News.
Scotland is now the only part of the UK which has approved PrEP for use on the NHS.
Robert McKay, National Director for Terrence Higgins Trust Scotland said:
“Today, Scotland has made history. We are delighted that people at risk of HIV in Scotland will finally have access to this ground breaking pill that will protect them from HIV. This makes Scotland the first country in the UK to routinely commission PrEP on the NHS.”
George Valiotis, Chief Executive of HIV Scotland, said:
“HIV Scotland welcomes this great decision that we have spent years campaigning for as an essential addition to Scotland’s HIV prevention approach. 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.”
The benefits of PrEP to NHS budgets have also been highlighted by campaigners. Treatment for a patient with HIV is estimated to cost over £360,000 over a lifetime however the cost of Truvada, back in 2015 in data supplied to HIV Scotland, was around £4300 per year. The exact cost of the deal done in Scotland is not yet known, although Scottish Government Health Minister, Aileen Campbell, said she hoped the manufacturers could come up with a “fair price” in answer to a parliamentary question in November.
Politicians have continued to add pressure on the Scottish Government over the past few years, with a number of questions raised in Holyrood by Patrick Harvie, Ben Macpherson, Alex Cole-Hamilton and Labour Leader, Kezia Dugdale.
The World Health Organisation has recommended PrEP as a worldwide preventative choice for individuals, encouraging people to consider this together with condom usage and safe sexual choices.
In the year to 31st December 2016, there had been 285 new HIV transmissions in Scotland, the lowest number of new cases in the past ten years. There are reported to be 5276 people living with HIV in Scotland today.
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