NHS England and Public Health England have given an outline of a large study of the best way for the NHS to implement pre-exposure prophylaxis (PrEP), which is due to start in the middle of next year. This follows the Court of Appeal’s ruling last month that NHS England, alongside local authorities, has the power, but not the obligation, to fund PrEP and should plan how to provide it.
While many activists would have preferred the NHS to announce an immediate roll-out of PrEP to all who need it, there was also the risk that the NHS would have decided that PrEP was too expensive to provide at the moment.
The study may allow a significant number of people to get access to PrEP – around 10,000 people may take part over a three-year period. A large trial may be possible because NHS England and Public Health England are trying to drive the price of PrEP drugs down by pitting generic companies and Gilead (the pharmaceutical company that produces Truvada) against each other in a bidding war.
We know that the study will not be directed exclusively at gay men or any other population, but very few details of the trial have been settled. It is not clear whether the trial will be run at sexual health clinics across England, or only in a few selected locations.
Deborah Gold of the National AIDS Trust, which took NHS England to court, said that the trial would not be happening without the legal challenge, a series of parliamentary questions and strong community pressure for PrEP.
“We are absolutely delighted that following our wins in Court, NHS England, working with Public Health England and local government will be now making PrEP available on a large scale, and quickly, to those who need it”
Greg Owen of iwantPrEPnow welcomed the announcement but said that the plans are not a permanent solution to wider PrEP provision. He called on NHS England to ensure that the limited availability of PrEP is targeted so it does not worsen existing health inequalities.