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NHS to launch three-year HIV drug PrEP trial

Pills for Pre-Exposure Prophylaxis (PrEP) to prevent HIV

After a High Court ruling by the NHS announcing they did not have the power to legally commission HIV drug PrEP, it has been announced that NHS England will now fund a major extension of the national HIV prevention programme.

It will aim to support those most at risk and reducing the incidence of HIV infection, also deciding to commission ten new specialised treatments

The first phase of implementation will be the launch of a large scale clinical trial in early financial year 2017/18.

According to NHS England, the evidence around the clinical effectiveness of PrEP is strong, however advice from Public Health England has highlighted questions that should be answered prior to using PrEP on a larger scale in England. The questions will be answered by the clinical trial, which could pave the way for full rollout.

The clinical trial phase will include at least 10,000 participants over the next three years, with NHS England fully funding the cost of the trial and will work in partnership with local authorities, the Local Government Association and Public Health England to use the findings as part of a wider national rollout.

Up to £10 million will be made available over the next three years to fund all aspects of the trial. Next steps will include asking both the manufacturer of the branded PrEP drug Truvada, as well as generic manufacturers to make proposals to participate in the trial.

Dr Jonathan Fielden, Director of Specialised Commissioning and Deputy National Medical Director, NHS England said: “We’re pleased to be able to announce funding not only for ten new specialised treatments but also a new ground breaking national programme for PrEP that will benefit at least 10,000 people.

“This has, in part, been made possible by the willingness of many pharmaceutical and device companies to come forward with lower and more responsible prices. Continuing this constructive joint working will enable us to fund more new drugs and treatments in the future.

“We have however, had to make some tough decisions over what we are not able to fund at this point in time within the resources we have available. We will ensure those treatments have the opportunity to be considered as part of the next annual prioritisation round in spring 2017.”

Ian Green, Chief Executive of HIV charity Terrence Higgins Trust, welcomes the news that PrEP will be available to 10,000 people over three years, however he says there are questions that still need to be answered. “We need to know how it will work in practice and understand how those at risk, no matter where they live, will be able to access PrEP.

“This trial alone does not provide the long-term stability that is needed – NHS England must make a commitment now that when the trial ends they will fully fund PrEP for all those who are at risk. Only then can we look forward to a future without HIV transmissions, which would be a stunning achievement in terms of public health.”

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