Hundreds of prescriptions for a “revolutionary” HIV-prevention drug have been approved in the first few months of it being more widely available.
Pharmac expanded access to Truvada in March. In the first three months, 695 people got the medication for the first time, paying $5 for a three-month prescription.
In June, another 152 people were prescribed Truvada, while 144 renewed their prescription.
The drug, also known as PrEP or pre-exposure prophylaxis, is a daily pill taken by those who’re at higher risk of contracting HIV such as gay or bisexual men, transgender people or those with an HIV-positive partner.
The drug’s been described as “revolutionary” by the NZ AIDS Foundation (NZAF), and Executive Director Dr Jason Myers says the uptake is encouraging.
“PrEP is one of the prevention tools that will help drive down the number of new HIV infections in New Zealand,” he says.
“While it is difficult to crystal ball gaze, it is the effective implementation of these tools at sufficient scale that could legitimately see an end to new HIV transmissions in New Zealand.”
From July 1 the cost to Pharmac of subsidising the medication dropped around 77 percent – down from $838.20 for 30 tablets to $190.02 (from $2514.60 down to $570.06 for a three-month prescription).
The cost reduction came through “competitive procurement processes”, a spokesperson told Newshub Nation, and Pharmac is working to reduce that even further.
Pharmac expects Truvada will eventually be subsidised for around 4000 people each year at a cost of around $6,840,720 per annum – assuming a patient is on funded treatment for 9 months of the year.
Research commissioned by NZAF has shown that a person infected with HIV can cost the health system up to $1 million over their lifetime, if they’re diagnosed in their 20s.
“Funding PrEP for those at significant risk of acquiring HIV, even at the original $838.20 per month price tag will result in significant long term savings to the New Zealand health system,” says Dr Myers.
“The decrease of the subsidised price to $190.02 is good news and only further enhances the cost-benefit analysis that shows the clear fiscal sense in funding PrEP.”
Dr Myers disputes claims that PrEP could see an increase in the spread of other sexually transmitted infections (STIs), due to reduced condom use.
He says overseas modelling has predicted the mandatory three-month sexual health tests for those on PrEP will actually decrease the number of new STI infections.
“If you imagine that someone who was previously being tested for STIs once a year – or not at all – is now being tested four times a year, then we should see STIs being treated much more quickly, which means they’ll be passed on at a much lower rate,” he says.
NZAF wants to see and end to new HIV transmissions by 2025 and Dr Myers says PrEP is one of the tools that will be vital in achieving that goal.
“Condoms are another, and we also know that if someone living with HIV is successfully treated and has maintained an undetectable viral load for more than six months, then HIV isn’t passed on through sex,” he says.
“So we now have three very effective HIV prevention methods.”
HIV infection rates had been on the rise in New Zealand since 2011, with 243 diagnoses in 2016 – the worst year since records began in 1985.
However, it’s hoped a 20 percent drop in the number of diagnoses in 2017, to 197, is the beginning of a downward trend.
“We don’t know exactly why this [drop occurred], but it’s very likely that increased PrEP usage played a part,” says Dr Myers.
By John-Michael Swannix