The NHS will spend millions of pounds on life-long treatment of individuals who acquire HIV infection whilst waiting to access PrEP, a new study has warned. The cost comes in addition to the harm to patients' wellbeing.
The researchers identified a list of 1,073 people who were awaiting PrEP and not enrolled in trials, over the two years to November 2019. Of these, 520 (48.6%) were still awaiting recruitment in a PrEP trial, and 200 (18.64%) had been contacted and deemed ineligible according to PrEP trial criteria. A further 32.1% had not responded to contact.
- 15 new HIV infections in people awaiting PrEP were identified through electronic medical records.
- Over half of these (N=9; 60%) had been eligible at first referral but had not met the PrEP trial eligibility criteria at the point of contact.
- At an estimated lifetime cost for HIV treatment of £360,800, these 15 infections alone will cost the NHS £5.4 million.
- Wider provision of PrEP may encourage increased attendance at HIV services, and funders must consider additional resources for clinics to accommodate this.
The authors call for the immediate roll-out of universal PrEP on the NHS. At the time of final article submission on 21 March 2020, the NHS had recently announced funding for eligible patients, but further details are still awaited. While implementation is delayed, patients waiting for PrEP are coming to harm, the authors note.