If the NHS was ‘for sale,’ what would it mean for PrEP?

Jeremy Corbyn holding a dossier of UK-US talks

Jeremy Corbyn has claimed that a Conservative government would put the NHS “up for sale” in order to strike a US trade deal, resulting in higher drug prices.

At a press conference on Wednesday, November 27, the Labour leader brandished a 451-page dossier of “secret” UK-US talks.

Corbyn claimed the papers prove that the US is “demanding” access to our health service as part of a future trade deal.

“Under Boris Johnson, the NHS is on the table and will be up for sale,” he said.

The independent fact checker Full Fact says that the leaked documents (which were posted to Reddit over a month ago) detail six meetings which took place between July 2017 and July 2019, before Johnson became Prime Minister.

During talks, the American side raised the issues of pharmaceutical patents and drug pricing. The US wants longer patents for American drugs, which would limit the NHS’ ability to buy cheaper, generic versions.

According to Corbyn, “Longer patents can only mean one thing: more expensive drugs.”

Johnson has denied that the NHS “is on the table in any way,” and Full Fact asserts that while the documents show the US bringing up health and pharma-related issues, “they do not give an indication of the extent to which UK negotiators agreed with the US position.”

But Matthew Hodson, executive director at the HIV charity NAM, told PinkNews: “It seems clear that the US is keen on creating trading environments that benefit their big businesses, including pharmaceutical companies.”

What does it mean for PrEP?

In the US, a monthly supply of PrEP can cost up to $2,000 per month, with Gilead Sciences maintaining a monopoly on the market due to its (contested) patents.

The British High Court overturned Gilead’s patent back in September 2018, allowing the NHS to purchase cheaper generic pills.

Because PrEP is out of patent in UK, any changes to the rules would, in theory, have no effect on prices.

“It seems unlikely that it would be possible to retroactively impose a longer patent on any drug where the patent has already expired,” Hodson explained.

However, while PrEP should be safe, Hodson warned that if the UK leaves the EU and its European Medicines Agency, “it will take longer for new drugs to be licensed, so the UK will be slow to benefit from drug development.”

“Further, the lack of backing from the EU may put the UK in a weaker position when negotiating drug prices,” he added.

“Currently we pay much lower prices for drugs in the UK than they do in the US, so it’s a concern that we are changing our trading relationship in a way that may favour US businesses.”

Tories failed to mention PrEP in manifesto.

As it stands, PrEP is available as part of a limited trial in England, and is available through NHS sexual health clinics in Wales, Scotland and Northern Ireland.

Labour, the Liberal Democrats and the Green Party have all committed to a full-scale roll-out of the drug in their election manifestos. The Conservatives and the Brexit party both failed to mention the drug at all in theirs.

Debbie Laycock, head of policy at the Terrence Higgins Trust, told PinkNews that PrEP “remains the missing piece of our HIV prevention toolkit in England.”

“After the election we need to see immediate progress made,” she said.

“In parts of the country PrEP trial sites have closed to gay and bisexual men due to being oversubscribed.

“This is putting these men at increased risk of HIV and is simply unsustainable. The urgency underlines the importance of our joint election manifesto which calls for PrEP to be made routinely available from April 2020.”

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