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NHS warns other care is at risk because of HIV drug and vows to appeal High Court decision

Cancer patients and children with cystic fibrosis are among those who could lose out after NHS England was told it should fund Prep

Deborah Gold

CHILDREN with cystic fibrosis and cancer patients are among the people who will lose out following a High Court decision about an HIV drug, health bosses say.

At the court it was ruled that NHS England is responsible for providing a pill to prevent HIV infection in gay men.

 National Aids Trust chief executive Deborah Gold is delighted after her charity won the High Court battle with the NHS over the preventative treatment for HIV
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National Aids Trust chief executive Deborah Gold is delighted after her charity won the High Court battle with the NHS over the preventative treatment for HIVCredit: PA:Press Association

But it is set to appeal yesterday’s judgement – because it says it means it will be unable to afford nine other treatments.

Treatments on hold while it considers the HIV medicine include a drug to help children with cystic fibrosis breathe, stem cell transplants for a rare blood cancer, a prosthetic knee for amputees and brain implants for children with hearing problems.

The High Court ruled NHS England can pay for the HIV medicine pre-exposure prophylaxis (Prep), if it is shown to be cost-effective.

This would be given to up to 10,000 gay men who don't have HIV but have a high risk of being infected through unprotected sex.

 Truvada is available privately on doctor's prescription and yesterday the High Court ruled it should be available on the NHS
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Truvada is available privately on doctor's prescription and yesterday the High Court ruled it should be available on the NHSCredit: Getty Images
 A conceptual view of HIV within the bloodstream. Prep works by blocking the enzyme that would otherwise allow HIV to replicate itself
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A conceptual view of HIV within the bloodstream. Prep works by blocking the enzyme that would otherwise allow HIV to replicate itselfCredit: Getty Images

Trials have shown that Prep, trademarked Truvada, is 92% effective at preventing HIV as long as the pills are taken every day.

It works by blocking an enzyme that would otherwise allow HIV to replicate itself and spread around the body.

NHS England – which funds drugs – had initially refused to prescribe the drug because it said as it is a preventative medicine it should be funded by local councils.

But this was challenged by the National Aids Trust charity and yesterday at the High Court Mr Justice Green dismissed NHS England’s argument.

Deborah Gold, from the National Aids Trust, told : “PrEP works. It saves money and it will make an enormous difference to the lives of men and women who are at risk of acquiring HIV.

“The delay to commissioning PrEP is unethical and expensive.”

And she said it is “deeply unhelpful” for NHS England to play off treatments against each other.

She said: “NHS England press releases now appear to be pitting PrEP against other treatments.

“Had NHS England not unlawfully pulled PrEP from its decision-making process in March, all prioritised new policies and drugs would now already be funded.”

And Tory MP Philip Davies told : “There isn't a bottomless pit to spend on the NHS.

“We've got to prioritise and decide where we should rank this in the list of NHS spending priorities.

“The fact that we're depriving cancer patients of crucial drugs at the expense of other treatments is something we've got to look at.

“You can't fund everything on the NHS.

“You've got to wonder what reaction you'd get if you looked a cancer patient in the eye to explain you haven't been able to fund their treatment because you've prioritised other treatments.”

 Dr Jonathan Fielden said NHS England would rate the HIV treatment against other priorities and ask the drug company to get the costs down
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Dr Jonathan Fielden said NHS England would rate the HIV treatment against other priorities and ask the drug company to get the costs downCredit: BMA
 A "game changing" decision made at London's High Court means NHS England can fund a preventative drug to treat HIV
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A "game changing" decision made at London's High Court means NHS England can fund a preventative drug to treat HIVCredit: Alamy

Prep is available privately with a doctor’s prescription at a cost of about £400 per patient a month, but if it becomes available through the NHS it would want to pay a much lower amount.

This cost is much cheaper than the £15,000 a year it costs to treat someone diagnosed with HIV.

Jonathan Fielden, NHS England’s director of specialised commissioning, said it would rate the HIV drug against other priorities.

He said: “Of course, this does not imply that Prep — at what could be a cost of £10 million to £20 million a year — would actually succeed as a candidate for funding.

“In those circumstances, Gilead, the pharmaceutical company marketing the Prep drug, Truvada, will be asked to submit better prices.”

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