Why PrEP is unavailable on the NHS

If PrEP is so promising, then why can’t we get it? The crux of this issue comes down to pricing. The drug company that has developed PrEP, Gilead, have placed the cost of it so high ( in order, they say, to recoup the costs of development ) that the NHS claim they can't justify paying for it. This has led to an ongoing fight between HIV activists and charities, the NHS, and the drug company. As of June, reports the BBC , an NHS watchdog has even been asked to evaluate the NHS’s decision not to onboard PrEP. As it stands, Gilead want to charge around £355 per person per month in the UK for a course of PrEP.In the mean time, unsurprisingly, the disparity between cost and need is aggravating people. Donna Riddington, 43, is an artist and HIV activist living in London. She says: “As someone who watched friends die one after the other through the early 90s from AIDS-related illnesses, to see pharmaceutical company’s greed again standing in the way of essential medicine to prevent HIV infection is a disgrace.”Dr Sarah Fidler, Consultant in HIV medicine and Senior Clinical academic at Imperial College London agrees with Donna. "PrEP is an essential part of all HIV prevention approaches and must be made available now for those in need,” she states. “The immediate barriers to widespread PrEP implementation are unacceptable drug pricing and artificial division of the NHS funding pathways.” In other words, the NHS are saying they can’t afford it, but Dr Fidler, for one, believes there is a way.What pisses a lot of people off in the PrEP conversation is the widespread belief that, if this HIV prevention drug were properly rolled out on the NHS, it would not only reduce the number of HIV diagnoses, but cost the tax payer less money in the long run. In the words of HIV drug pharmacist Collette Brydon, “PrEP should be funded as a vital public health initiative especially as we all know the costs of prevention are tiny compared to HIV treatment – think of the thousands of pounds which could be saved.”To make matters worse, as long as PrEP is not available via the NHS, people will find other ways to get hold of it. That could mean buying dodgy stand-ins on the web. “Without PrEP on the NHS,” explains Deborah Gold, “we won’t be able to ensure fair and equal access, and we risk an unregulated market buying PrEP from abroad, which carries risk of buying the wrong drug, drug resistance and wrong dosing. The moral imperative for PrEP is overwhelming.”