Funding PrEP Could Prevent HIV Infections and Save the UK Millions

A new study published in the science journal “Lancet Infectious Diseases“ suggests that funding the rollout of HIV prevention drugs, known as PrEP, could save the National Health Service £1billion over 80 years.

NHS England has been slow to grant PrEP access for gay and bisexual men throughout England and Wales. Since losing a court battle over PrEP, the health care system has set up a pilot trial granting access to 10,000 gay and bisexual men. But no full roll out has yet to be scheduled.

NHS England contends that it must carefully study both PrEP’s effectiveness and the cost benefits of the intervention.

In terms of cost, the recent University College London study makes the case that, while there would be an initial investment needed, the payoff would begin to materialize relatively quickly. After all, as HIV prevalence falls, the number of people requiring HIV treatment and care will also decline.  . 

The study examined the financial costs of making PrEP widely available to at-risk men who have sex with men, or MSM. By using existing HIV rate models — as well as data on PrEP’s effectiveness and wider health data gathered by Public Health England — researchers developed an understanding of how PrEP rollout might impact HIV prevalence among MSM.

The researchers found that, if 40,000 MSM could be given access to PrEP by the end of the 15th year of rollout — assuming uptake continues at a steady pace — around 25 percent of total predicted HIV infections would be prevented. And PrEP would specifically avert about 42 percent of those infections.

It would take an estimated 40 years for PrEP to return the initial investment required, but that’s not unexpected. At first, the NHS would have to fund PrEP and life-long care for those living with HIV. However, as PrEP rollout continues and HIV rates go down, the NHS would see cost benefits.

The study’s models predict that, within 80 years, the NHS could save as much as £1billion due to PrEP availability — and that’s just from a rollout tailored to meet the needs of the MSM community. It doesn’t account for a similar investment for intravenous drug users, for instance.

Dr. Valentina Cambiano from University College London explained:

There is no doubt about the effectiveness of PrEP. In addition to delivering a substantial health benefit, our work suggests that its introduction will ultimately lead to a saving in costs, as a result of decreased numbers of men in need of lifelong HIV treatment.

It’s important to note that these savings estimates were based on PrEP’s current prices. Leading PrEP drugs will become available on the generics market within the next five to ten years, meaning that they are likely to fall in cost. And, as a result, NHS spending could be recouped far quicker.

The study’s recruitment base made up just five percent of the total MSM population. Rolling out PrEP to wider groups would carry extra costs, but the benefits could also be substantial — so long as the treatment was well tailored and targeted.

HIV charity the Terrence Higgins Trust welcomed the new study, with Dr. Michael Brady of the Trust emphasized:

One of the key arguments against PrEP has been that it will cost the NHS too much money. This study firmly puts that claim to bed by demonstrating that, when appropriately targeted at those at risk of HIV, it is not only highly cost effective but, as the price of HIV drugs falls, will actually save the NHS money in the long run. Each HIV infection we prevent saves the NHS £360,000 of a lifetime of treatment and care.

Dr Brady adds, “The study also highlights the importance of cheaper, generic versions of PrEP, which are currently being used in NHS England’s PrEP Impact trial and have been commissioned for PrEP use in Scotland.”

England’s health body has reportedly welcomed the study as yet another piece of information on the benefits of PrEP. At present, however, there is no clear timetable for full rollout of PrEP. Given that HIV infections among the MSM community remain disproportionately high, pressure must continue for this vitally important health intervention.

Photo credit: Jason.

55 comments

Marie W
Marie W6 months ago

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KimJ M
KimJ M6 months ago

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KimJ M6 months ago

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KimJ M
KimJ M6 months ago

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KimJ M6 months ago

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KimJ M6 months ago

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Jim Ven8 months ago

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Jim Ven8 months ago

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Jerome S8 months ago

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Jerome S8 months ago

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