Pre-Exposure HIV Drug Would Save the NHS £1bn Over 80 Years Claims UCL Researchers

Wednesday 18th October 2017

A team of scientists from University College London have found that a drug that cuts the risk of HIV infection substantially during sex would save the UK a billion pounds over eighty years.

In what has been called a “no-brainer” for the NHS to undertake, the UCL team have suggested that the wide roll out of pre-exposure prophylaxis, or PrEP, would have a dramatic effect on reducing HIV cases in the UK.

The paper, published in the Lancet, focuses on providing PrEP to men who have sex with men, focused on a mathematical model related to the cost of providing PrEP, both as a daily drug to be taken continuously, as well as a model related to predicted behaviours, which would average to five pills a week over 4 and a half years. These options are also under investigation as part of NHS England’s trial of 10,000 patients,

Using this model, the team at UCL noted that it would take up to 40 years for the pill to become cost effective, owing to how NHS would be funding both treatment and lifelong care for people infected with HIV as well as PrEP as a preventative measure. In their model, in 40 years the savings for the dropping number of HIV cases would equal the cost of PrEP, and in 80 years the drug would deliver a saving of £1 billion.

There are a few variables here. If the drug was provided daily it would take slightly longer to become cost effective, and the long term cost of PrEP is also an unknown variable, with the potential of the drug falling in price dramatically as cheaper versions and alternatives become available.

Currently, PrEP is available widely in Scotland, however NHS England has not yet agreed to its wider user. A judicial review took place last year where the NHS argued that given the drug was a preventative treatment it could not legally provide funding for it, as preventative services were for local government to fund and commission. The NHS lost this case and its subsequent appeal, and afterwards announced it would fund a large-scale trial involving roughly 10,000 people, which would take place over the next three years.

This could be considered a major turning point in the fight against HIV and AIDS, along with increased testing, information and immediate treatment after diagnosis. There is, claims Dr Paul Revill from the University of York’s Centre of Health Economics, the prospect and potential of bending the curve of new HIV infections downwards in a way that appeared unfeasible only a few years ago. HIV, an infection still without a cure and that is still potentially lethal if it advances into AIDS, can be managed and treated and provide a nearly normal life, with lifelong treatment. Reducing the risk of people being exposed to HIV and managing the treatment of those living with it are two goals that are interlinked, and the NHS noted the “growing evidence” for PrEP being a cost effective treatment to help those with HIV.