BHIVA statement on the NHSE update on commissioning and provision of PrEP for HIV prevention

Tuesday 22 March 2016

"We are perplexed and deeply concerned by NHS England's decision not to take HIV pre-exposure prophylaxis (PrEP) to stakeholder testing and consideration by the Clinical Priorities Advisory Group (CPAG). The decision comes as a complete shock, following 18 months of hard work with NHSE and a comprehensive, expert stakeholder group, which supports this roadmap to a commissioning decision.

In addition to the results of the PROUD study - which proved the clinical effectiveness of PrEP - our work proves that it is a safe and cost-effective intervention that will prevent hundreds of people in the UK becoming infected with HIV. We cannot understand why NHSE has only now stated that the roadmap is invalid, when there is no evidence of objections by local authorities who would be responsible for delivering this intervention.

The NHSE's offer of £2 million over the next two years to run a number of early implementer test sites - while better than nothing - raises many questions, including how many people can be offered PrEP, how to prioritise individuals and how to avoid a post code lottery. There is a major risk that this approach will fail any sort of equality assessment, and it is not clear how it will add to the findings of the PROUD study.

We will now urgently seek clarification of the process required to reach a commissioning decision. If a decision cannot be reached by NHSE supported by a comprehensive array of stakeholders including local authorities, then we need to know who can make the decision and how it can be made.

This is yet another adverse outcome of the disastrous Health and Social Care Act, with potentially devastating consequences for real people. Any further delay in commissioning PrEP will mean many more people infected with HIV."