Scotland approves anti-HIV drug

Yesterday (Monday 10th April) Scotland became the first of the UK nations to approve the provision of PrEP (Pre Exposure Prophylaxis) by the NHS to prevent HIV.

Following a rigorous process the Scottish Medicines Consortium (SMC) announced that PrEP, the HIV prevention drug, has been deemed a cost-effective treatment to prevent the transmission of HIV and will be made available on the NHS in Scotland.

It has been shown in multiple studies that PrEP works to prevent new HIV infections.

The PrEP4Scotland Coalition (HIV Scotland, Terrence Higgins Trust Scotland, Waverley Care, and NAT (National AIDS Trust)) welcomed the announcement by the SMC approving PrEP on the NHS in Scotland for those who need it. In a joint statement the four groups 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.

George Valiotis, CEO of HIV Scotland said, “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.”

Robert McKay, National Director for Terrence Higgins Trust Scotland, said: “Today, Scotland has made history in the fight against the HIV epidemic. PrEP can now be used as a vital tool – 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 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.”

Deborah Gold, Chief Executive at 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.”

Grant Sugden, Chief Executive of Waverley Care, said: “This is a ground-breaking decision that has the potential to reduce new HIV infections and also improve the quality of life of at-risk communities in Scotland. HIV still looms large over the lives of many gay and bisexual men, with damaging consequences for their relationships, and their physical and emotional health. PrEP can play a role in addressing this, helping to rebuild confidence and self-esteem, and allowing men to lead healthier, happier lives.”

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.

Gordon Garioch, 53, from Aberdeen, is already taking a generic version of PrEP which he buys online. For him the news that it will be available on the NHS will make a real difference to his life. He commented:

“For me PrEP is a reassurance – I used to worry all the time. I have always been cautious, but some of my friends have been cautious and got HIV. Taking PrEP has allowed me to take control of my sexual health, and therefore both my physical and mental health.

“As well, I feel by taking PrEP I am being responsible to myself, but I am also being responsible to my sexual partners.”