Following a rigorous process, the Scottish Medicines Consortium (SMC) announce that PrEP, the HIV prevention drug, has been deemed a cost-effective treatment to prevent the transmission of HIV in Scotland.
The drug called Truvada will be made available on the NHS in Scotland in the next few weeks along with four other new medicines treating breast cancer, multiple sclerosis and leukaemia. Truvada has been proven in multiple studies to prevent new HIV infections.
The PrEP4Scotland Coalition which includes HIV Scotland, Terrence Higgins Trust Scotland, Waverley Care, and NAT (National AIDS Trust) has welcomed the announcement by the SMA.
A spokesperson for PrEP4Scotland Coalition, said: “We applaud the SMC for taking this bold step to tackling HIV in Scotland. PrEP provides opportunities to reinvigorate how people at higher risk of HIV exposure engage with testing and prevention opportunities, and it is a vital opportunity to make a real reduction in the number of new HIV transmissions.”
“All NHS Boards in Scotland need to now follow the SMC’s advice and ensure they’re making PrEP available to those who need it, so that no-one at risk is left behind.”
To get to this stage hundreds of community members across Scotland have contacted coalition members, attended information events, contributed to consultations, appealed to clinics, and spread the word on PrEP.
This outcome was only made possible by these collaborations and shows what progress can be made when professionals and the community join together to learn from each other and find solutions.
Robert McKay, National Director for Terrence Higgins Trust Scotland, said: “Today, Scotland has made history in the fight against the HIV epidemic, becoming the first country in the UK to routinely commission PrEP on the NHS. People at risk of HIV in Scotland will finally have access to this groundbreaking pill that will protect them from HIV.
“It can now be used as a vital tool in our HIV prevention armoury – alongside condom use, regular testing and early treatment – to help bring an end to HIV transmission in Scotland. Not only will this make a life-changing difference to each of these individuals by protecting them from a lifelong and stigmatised condition, but for every person who would have become HIV positive without PrEP, NHS Scotland will save £360,000 in lifetime treatment costs.
“We applaud the Scottish Medicines Consortium for acting on the overwhelming evidence for the clinical effectiveness of PrEP, and taking this trailblazing step to tackling HIV in Scotland.
“It is brilliant to see Scotland leading the way in stopping HIV transmission – but there’s a long way to go before everyone at risk in the UK has access to PrEP.
“NHS Boards in Scotland now need to make sure they heed the expert advice from SMC and make PrEP available to their patients who are identified as at risk of HIV as a matter of urgency.
“NHS Wales makes its decision on PrEP later this month, and we hope they will follow Scotland’s leadership in preventing HIV.
“Meanwhile a long-awaited PrEP trial from NHS England and Public Health England is still yet to materialise. We urgently need answers on when exactly the trial will begin and who will have access to it, and ultimately, assurance that the NHS will retain responsibility for PrEP in England when the trial comes to an end.
“We must not let PrEP become a postcode lottery – it should be available to all those at risk, regardless of where they live.”
George Valiotis, CEO of HIV Scotland, added: “HIV Scotland welcomes this great decision that we have spent years campaigning for as an essential addition to Scotland’s HIV prevention approach. In 2016 HIV Scotland published a PrEP good practice guide, and administered Scotland’s expert group which produced prescribing criteria, cost assessments, and mapped information and training needs of workers and the community.”
In December 2016 the drug’s manufacturers applied to the SMC to make Truvada, which is already used to treat HIV, available on the NHS in Scotland as a prevention treatment. Following the submission, the coalition coordinated a Patient Group Submission to make sure that the voices of people who would benefit most from access to PrEP were represented.
More than 350 people responded to the consultation survey distributed by coalition members, with the vast majority in favour of making PrEP available.
It’s estimated that up to 1,900 people north of the border could benefit from the drug, which costs about £450 a month.
Deborah Gold, Chief Executive at National Aids Trust (NAT), said: “NAT is delighted at the announcement that PrEP will be made available throughout Scotland within a matter of weeks. This game-changing prevention tool has the potential to massively reduce HIV rates and turn Scotland into a model internationally of how to do HIV prevention well. The speed and decisiveness of the Scottish process contrasts starkly with delays in the other three UK nations.”
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