NHS England: Pre-exposure Prophylaxis for People at Risk of HIV

Lord Hunt of Kings Heath Excerpts

Tuesday 7th June 2016 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

I am grateful to the Minister but this decision by NHS England not to commission and fund PrEP is a matter of great regret. In the UK there are more people living with HIV than ever before. Without any need for an evidence review, it is absolutely clear, without any uncertainty whatever, that PrEP has the potential to be a game-changer. It is proven to be effective in stopping HIV transmission in almost every single case. There is no need for an evidence review. It is simply a delaying tactic because of this absolutely disgraceful decision not to fund this drug. The Minister mentioned our record in relation to other countries. It is a matter of shame that this drug is being used extensively in other countries but is being denied to NHS patients without any justification whatever.

At some point the Minister will pray in aid the cost of new drugs. On a number of occasions I have asked him this question but he will never answer it—because, I suspect, the answer is too embarrassing. He knows that he is in the middle of a five-year agreement with the branded drug industry through which, if the cost of drugs goes over the base level plus a small allowance for inflation, the department receives a refund every three months. That agreement should enable new drugs to be funded, but that money is not being used to invest in those new drugs. If he says that this cannot be done because of cost, that is simply not true. I very much hope that the Government will reconsider this decision. It is utterly indefensible.

[Lord Prior of Brampton]

My Lords, I am not going to proffer the argument that it is too expensive, because that is not the issue today. The issue today is that NHS England feels that it does not have the power to commission this particular drug. Whether or not it has that power may well be judicially reviewed, so I cannot comment on the outcome of that judicial review.

The PROUD study produced strong evidence of the effectiveness of Truvada as a preventive drug. The work that NICE is going to do, and the pilot scheme to look at the effectiveness of this drug—it will cost £2 million and will be funded by NHS England and PHE—will ensure that when the question whether NHS England has the power to commission this drug is resolved, there will be the evidence on which to make that decision.