The Health and Safety Executive (HSE) is considering the possibility of waiving payment to access the emergency department currently required before a patient can be given HIV post-exposure prophylaxis (PEP) in a bid to make the HIV prevention drug accessible to more people in the UK.
PEP is a combination of antiretroviral drugs and if taken properly in strict adherence of the dosage it can stop HIV infection from taking place by up to 80%. PEP is most effective when taken within a 72 hours window after being exposed to the HIV virus. This means that accessing the drug as soon as possible is very important if it’s going to be effective.
In the UK, PEP is currently available in various locations including sexual health clinics and primary care facilities. The only problem is that these facilities are only open during specific times each week.
Though PEP is available 24/7 via hospital emergency departments, the patient has to pay for it. To access PEP at an emergency department you must pay €100.
Such a fee can be cost restrictive to accessing the drug to most people who are normally in urgent need for it. This also discourages people from visiting an emergency department in the event of getting exposure to HIV leaving them at high risk of getting infected.
What is PEP?
PEP is considered an emergency antiretroviral therapy (ART) that is given to people who suspect that have come into contact with the HIV virus. This could be through sexual contact (rape, broken condom, shared drug injecting needles) or through occupational exposure in the case of healthcare workers.
The drug once taken should offer protection against acquiring the virus. It should be taken before 72 hours have elapsed from the time of exposure. The sooner you start treatment the more efficient the drug will be.
The drug is then taken either once or twice daily for 28 consecutive days. It is important that you do not miss any day of the PEP course otherwise this will affect the drug’s efficiency.
Legality of The Waiver
The HSE is currently verifying whether it is legal to waive the €100 fee in order to reduce the barriers to accessing PEP and make it possible for more people regardless of their financial status to access the drug within the window period.
HIV prevention advocates have urged the HSE to lift the fee saying that it would greatly help in advancing their efforts to eradicate new HIV cases by 2030. Meanwhile, Gilead Sciences lost its court case in which it seeking to block the sale of generic Truvada within Ireland.
Truvada is a combination drug used for HIV PEP and pre-exposure prophylaxis (PrEP) prevention drugs as well an ART to treat people who are living with HIV. The original brand of Truvada sold by Gilead retails at around €400 per month and the company makes around €24 million per year in sales from Ireland.
Mylan and Teva who are selling the generic version of Truvada enables people to save up to 60% in the cost of the drug. This will save the HSE millions, making it possible to waive the current fee.