Wales will trial the use of HIV-preventing PrEP drugs for at-risk groups, in spite of a negative review from the country’s medicines body.
Pre-Exposure Prophylaxis (PrEP) drug Truvada can drastically reduce people’s chances of being infected with HIV, and is available in a number of countries to at-risk groups including sex workers, gay men, and people in serodiscordant relationships.
Health experts say rolling out PrEP in the UK would be cost-effective if it leads to even a small reduction in HIV infections, as the lifetime cost of just one HIV infection can in excess of £300,000.
Due to devolution of healthcare, PrEP provision is being separately assessed in England, Wales and Scotland.
Earlier this week the All Wales Medicines Strategy Group broke with the consensus from England and Scotland to advise against providing PrEP on the NHS.
But the Welsh government has today confirmed it will push ahead with a trial of PrEP regardless.
The trial will provide the drug “to all those who would benefit from the preventative treatment”, beginning this summer and running for at least three years.
Announcing the move, Health Secretary Vaughan Gething said: “There is no doubt that Truvada reduces rates of HIV infection when taken correctly and supported by wider, preventative sexual health services can help to reduce overall HIV transmission and infection rates.
“This is the advice of the World Health Organisation.
“The study that I have announced will mean that all those for whom the drug is clinically appropriate can access it.
“The study will help us to learn how best to provide the preventative treatment to reduce risks of HIV transmission in Wales and answer some of the questions raised by the All Wales Medicines Strategy Group around incidence rates.
“The All Wales Medicines Strategy Group is a highly regarded, independent expert group.
“I acknowledge their advice that there are uncertainties regarding cost-effectiveness and that they have not recommended the drug for routine use within NHS Wales at this time.
“I am asking Public Health Wales and the HIV Expert Group to work together to deliver the study.”
Sarah Fuhrmann, National Director for Terrence Higgins Trust in Wales, said: “We are heartened and relieved that the Welsh government have listened to people affected by HIV, and will make PrEP available to people who need it in Wales, through a three year trial.
“Although this is not a long-term solution, it is undoubtedly a momentous step forward for Wales, where investment in HIV prevention has been patchy at best. Making PrEP available to people at risk of HIV will not only protect them from a lifelong and stigmatised condition, it will also save our NHS £360,000 in lifetime treatment costs for every person who would have become HIV positive without PrEP. Common sense has prevailed.
“A trial is only ever a temporary answer, however, and we will be looking to the government to commit to making PrEP routinely available in Wales for those at risk, as Scotland has already done. We must not see the same delays or uncertainty that we’ve seen in England around PrEP.”
Scotland has become the first part of the UK to approve the use of PrEP as HIV prevention, with the Scottish Medicines Consortium giving the green light last month.
In England, PrEP will be made available to at-risk gay men through a trial set to be rolled out at sexual health centres this summer.