NHS can fund HIV prophylaxis - court

A court in England has ruled that England’s National Health Service can pay for Gilead’s Truvada in its use in HIV prevention, after campaigners took legal action over the organisation’s refusal to fund it.

NHS England refused to pay for Truvada (emtricitabine+tenofovir) earlier this summer, saying that it was down to councils to fund preventive treatments.

In a High Court ruling, Mr Justice Green, said there was nothing to stop the NHS paying for the drug. But NHS England says it will fight the decision, arguing that paying for the drug could jeopardise funding for other treatments and services.

The National Aids Trust (NAT), which challenged NHS England’s stance in the courts, said the ruling is “vindication for the many people who were let down” by the decision to axe pre-exposure prophylaxis (PrEP) funding in June.

However the NAT said it is “enormously disappointing” that NHS England has decided to appeal this judgement.

The appeal will mean any potential commissioning of PrEP will not take place for months.

There will be a 30-day public consultation on PrEP, which the NAT said should begin almost immediately.

An NHS England committee will consider the case for commissioning, but a final decision and commissioning will depend on the outcome of the appeal.

NHS England had previously suggested that funding for a national scheme would be available, but after 18 months of preparation it backed down and said it would pay for only a handful of pilot sites.

The PROUD study had provided the clinical basis for PrEP in high-risk individuals in England, and this was further reinforced when European regulators said the drug could be used in this indication late last month.

Ian Green, chief executive of the Terrence Higgins Trust HIV charity, said: “Because of the mess and delays created by NHS England, people at risk of HIV have spent the past 18 months fighting to be heard, meanwhile 17 people have been diagnosed with HIV with every day that has passed."

Green said that many people were coming off the PROUD trial this month.

“Unless NHS England acts rapidly, it is only a matter of time before some of these people become HIV positive. PrEP must be prioritised and made available now.”