The Pharmaceutical Benefits Advisory Committee (PBAC), announced that it will defer recommending the listing of Pre-Exposure Prophylaxis (PrEP) on the Pharmaceutical Benefits Scheme (PBS) – an unfortunate delay in making this powerful HIV prevention strategy available and affordable to all Australians.
While it’s disappointing a recommendation has not been made, on an optimistic note, the deferral means that with efficient additional work, PBAC may recommend very soon, for PrEP to be listed on the PBS.
What is PrEP?
If you’re HIV negative, PrEP is a powerful strategy that uses medication to protect you against HIV, and it can be accessed now via clinical studies in almost all Australian states and territories. If you don’t live in a state or territory with a study currently running, or if the study running in your state or territory is full, you can see your GP about obtaining a prescription and importing it yourself, at an affordable cost from overseas.
There is currently a push to make PrEP available to purchase at an affordable price in Australian pharmacies with a prescription from your doctor, but this will depend on future recommendations from PBAC.
“‘PrEP is essential for the prevention of HIV in Australia and we encourage PBAC and the two sponsoring companies, Mylan and Gilead, to move quickly with their negotiations,’ says ACON CEO Nicolas Parkhill.”
In 2016, the first PrEP medication to be listed and approved by the Therapeutic Goods Administration (TGA) for sale in Australia was Truvada. However, the drug was not recommended for listing on the PBS, making it largely unavailable to most Australians due to the excessive cost (roughly $10,000 per year).
“‘Gay men need access to all the proven tools to ensure success in driving down new notifications across the country,’ says VAC CEO Simon Ruth.”
When will subsidised PrEP next be submitted for PBAC’s recommendation?
A deferment means that PBAC may be willing to subsidise the cost of PrEP, however PBAC needs to negotiate further with the sponsoring company to work out the details. These negotiations may be on price, distribution channels or a number of other issues. There is no exact timeframe for this process, but it is possible that it can move quickly from here.
There are concerns that delays in providing affordable access to PrEP increases the likelihood that people will contract HIV who would not have otherwise. While it is important to have strong and robust processes , these periods of delay can have health consequences.
“‘Those who are interested in starting PrEP should speak to their doctor or contact their local AIDS Council for more information,’ says Parkhill.”
What does this mean for people currently taking PrEP?
If you’re currently enrolled in a PrEP study, you should continue taking your PrEP as prescribed by your PrEP study doctor.
On the other hand, if you’re currently importing generic PrEP from overseas via the Personal Importation Scheme, you should continue to obtain PrEP in this manner, despite the PBAC’s decision to defer the listing of PrEP on the PBS.
What does this mean for people not currently taking PrEP and people living with HIV (PLHIV)?
If you’re HIV negative and not currently taking PrEP, it’s important to continue to employ a sexual health strategy, whether that be condoms and lube, knowing whether your sexual partner has an undetectable viral load (UVL), or Post-Exposure Prophylaxis (PEP). It’s also important to get tested at least every six months.
If you’re considering PrEP, you may be able to access it via a study (depending on which state or territory you are located in), and all Australians can import generic PrEP from overseas via the Personal Importation Scheme.
If you’re a person living with HIV (PLHIV), you can continue to maintain your own good health and protect your HIV negative partners, who are not on PrEP, by having an undetectable viral load (UVL) for six months or more.
Emen8 | Undetectable = Safe
“PrEP is essential for the prevention of HIV in Australia and we encourage PBAC and Mylan/Gilead to move quickly with their negotiations. PrEP is a proven technology and we have already seen a significant impact in the NSW context through the EPIC-NSW study. While the negotiations continue, people who are on PrEP should continue accessing it through existing channels, and for those who are interested in starting it, they should speak to their doctor or contact their local AIDS Council for more information,” says Parkhill.
“Gay men and others affected by HIV have been proactive in making responsible decisions about HIV risk and we need access to all the proven tools to ensure success in driving down new notifications across the country,” says Ruth.