Question to the Department of Health and Social Care:

To ask Her Majesty’s Government why NHS England has refused to pay the costs of making available pre-exposure prophylaxis in order to protect men from HIV.

Pre-exposure prophylaxis (PrEP) is a new use of HIV drugs which has shown clinical effectiveness in research trials at preventing HIV in people at high risk of getting HIV such as men who have sex with men (MSM) and people with HIV-positive partners. The drug used in the trials, Truvada, is not yet licenced for use as PrEP. Public Health England (PHE) has undertaken modelling work looking at cost-effectiveness of PrEP. Much depends on the price of the drugs and HIV prevalence in the target group. However, as with any new intervention, PrEP now needs to be properly assessed in relation to cost effectiveness to see how it could be commissioned in the most sustainable and integrated way and how it compares with other cost-effective approaches. The Department is considering this with PHE, NHS England and the National Institute for Health and Care Excellence.

NHS England has agreed to carefully consider their position on commissioning pre-exposure prophylaxis (PrEP). Planning continues on the early implementer tests sites in the meantime. Irrespective of the commissioning arrangements for PrEP, decisions to fund will depend on full assessment of clinical and cost effectiveness and how it can be integrated with other HIV prevention efforts.