High Court reviews NHS decision to avoid commissioning HIV-preventing PrEP drugs

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The High Court today heard a sexual health charity’s challenge against a decision not to commission HIV-preventing drugs.

Pre-Exposure Prophylaxis (PrEP) drug Truvada can reduce people’s chances of being infected with HIV by up to 99 percent, if taken daily.

Though the drug is endorsed by the World Health Organisation and is available to at-risk gay men in a number of countries, NHS England has repeatedly deferred a decision on the drugs – despite a pilot scheme showed the drugs were incredibly effective at reducing HIV transmission among men who have sex with men (MSM).

This week, NHS England ruled out a large scale roll-out for PrEP instead funding a further two-year trial at “early implementer” sites – claiming that it does not have authority to commission the drugs.

Sexual health groups said the decision puts men at risk, while London Councils accused the NHS of “playing a waiting game”, stringing out a decision until drug patents expire.

Today the National AIDS Trust went to the High Court to challenge the legality of NHS England’s decision to remove PrEP from its commissioning process.

The filing questions why NHS England had consulted on making PrEP available in the first place, given it now retroactively claims it has no legal authority to do so.

Meanwhile, NHS England insists that “Local authorities are the responsible commissioner for HIV prevention services” and that “NHS England is not responsible for commissioning HIV prevention services’”

The charity says it expects a ruling in a “few weeks”

Deborah Gold, CEO at NAT, said: “Local authorities do not have sole responsibility for HIV prevention in England. NHS England has a clear role in prevention.

“Our view, and the view of our legal advisors, is that there is nothing to prevent the NHS from commissioning PrEP should it wish to.

“This has highlighted a huge issue with our health system. It is simply unacceptable that we are having to go to court to clarify who has responsibility for commissioning such an important innovation.

“We are very hopeful that the court will agree with the case we are making.

“The outcome will have significant implications for future funding of public health interventions in this country. Not to mention the thousands of people who need access to PrEP now.”