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IRELAND’S HEALTHCARE WATCHDOG is looking at the feasibility of the government launching a Pre-Exposure Prophylaxis (PrEP) programme next year.
PrEP is a once daily medication that can significantly reduce risk of infection among HIV-negative people at high risk. To date, PrEP has only been available to buy in Ireland on prescription at a price of over €400 a month for the brand-name medication, and around €100 for the generic medication.
The Health Information Quality Authority (Hiqa) has been carrying out a Health Technology Assessment of a programme which would make the drug free for populations at substantial risk of contracting HIV and who hold a medical card.
The aim is to establish the clinical- and cost-effectiveness of providing a PrEP programme in Ireland, a statement from the Department of Health said this morning.
Hiqa’s work is due to conclude by early next year, for a possible roll out by 2019, as outlined in The National Sexual Health Strategy 2015–2020.
Considerable work has already been done by the HSE to prepare for the introduction of a PrEP programme.
Minister for Health Simon Harris said: “We know that enormous progress has been made in the treatment of people living with HIV.
However, we are also acutely aware of the significant numbers of people in Ireland being diagnosed.
“Prevention is absolutely essential and as Minister for Health I am keen to make PrEP, which is a prevention tool, more readily available to those at risk of HIV in Ireland.”
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It costs €85-95 (not over €400) per month on prescription.
@Philip Kavanagh: Is that not the cost to the consumer on the Drug Payments Scheme as opposed to the overall cost of the medication? Genuine question
@Philip Kavanagh: I’m guessing that’s the branded price rather that generic which is around the €100 mark
@Link: I’m not sure whether it is covered on the drug payments scheme, but with a prescription the maximum anyone should be paying (out of their own pocket) is €95 per month.
@Paul: Likely so. But the article should state that. There are already comments here complaining about the cost to the tax payer. The generic is just as effective as the branded product.
PrEP PrEP is proven to be safe and highly effective for HIV prevention and has played a significant role in reducing new HIV rates in every country where it’s been introduced. England, Scotland, Wales, Australia, France introduced PrEP for people that are risk and each country saw a huge drop in the past few years in new HIV numbers. We can finger wag at people all day about not using condoms correctly or consistently every time we have sex , but if you are truly honest with yourself there were times when most of us didn’t and that how most people get HIV. PrEP isn’t meant to replace condoms, it just adds another option to the growing range of tools we have to prevent HIV transmission. Using PrEP doesn’t mean you have to stop using condoms, it just means you don’t have to worry about HIV if you do. When you fighting a battle you don’t need every available tool at your disposal. Regular testing, condoms, PrEP – The reason that HIV has raised it’s ugly head again in Ireland at high number is because current and successive Government took there eye of the ball. Sex education in schools even today are a joke, there’s a culture of shame and stigma around sex and sometimes when people are horny, drunk or high they make poor decisions.
@Will St Leger: Point taken, can I ask if you’d advocate PrEP for everyone, in which case you’d have to recognise the cost involved. I appreciated there’d be significant costs in treating HIV too and hate the idea of reducing something like this to a cost/benefit analysis.
@Boyne Sharky: Yep, cost is factor in any decision making:
Generic PrEP pill costs less than €1 per pill and should be available to the relatively small number of people who need it (few thousand), whereas one HIV treatment pill costs €49 per day (paid by taxpayer for the rest of that patient’s life) The number of people needing HIV treatment is increase by about 500 people in ireland every year. It’s an economic no-brainer
@Will St Leger: Well said
I’d like to know exactly what places these people in the high risk category, is it lifestyle or perhaps drug use? If they can then maintain a strict drug regimen why not simply alter that which places them at risk, their lifestyle or habit?
@Boyne Sharky: same could be said for the “pill”……..
@Boyne Sharky: One tablet per day is hardly a strict drug regimen. On a similar note, the cervical cancer vaccine covers HPV, which can be sexually transmitted. Would you be willing to ask women to alter their “lifestyle”?
@Boyne Sharky: and why don’t alcoholics just stop drinking? Same logic.
We may not understand why people do the things they do, and put themselves at risk, but it’s a reality and why not make medication available to them that may help reduce the spread of HIV?
@Boyne Sharky: you say this because you just don’t like their ‘lifestyle’. HIV is a lifelong illness so it makes more sense to prevent than treat.
@Boyne Sharky: I wasn’t condemning or being critical, rather I was being curious, some may also be receiving blood products which may place them at risk. I guess if you’re told doing A (and I have no idea what that may be) places you at risk, is it more reasonable to say do an additional task, B, or just stop doing A.
@Paul: The pill also helps women who suffer from severe pain during their periods, that’s what it was originally developed for, the contraceptive aspect was a side effect.
@Boyne Sharky: Is it reasonable to only provide for a single solution when others exist? You don’t have to give just one piece of advice to people. The fact is that a person with HIV will cost the taxpayer far more than a person on PrEP.
You can provide advice on abstinence etc. while also providing for PrEP to reduce infection rates. Same as you can advise people as to abstinence etc. but still provide condoms/the pill at a free or affordable rate.
It’s about being realistic, people with HIV are in relationships and want to be intimate with their significant other. It is probably not reasonable to expect every single person with HIV to be abstinent and there exists a simple one pill solution.
A lot of HIV positive people will probably choose to remain abstinent anyway but what is the harm in having PrEP as an option for the partners those that won’t?
I think we all know why you were so reticent to this proposal even if you now realise it’s not a good look. Even now, your talk of what is “more reasonable” literally doesn’t apply anywhere. Seriously, give me a single example where it is “more reasonable” to deny access to a viable preventative medical treatment? Cancer? Diabetes? Any example at all.
Is this one of those instances where the taxpayer will pay for other people to take less responsibility for themselves? Imagine my shock
@Rob O’brien: It’s one of those issues where prevention is better – and cheaper – than cure.
@Rob O’brien: It costs more to treat a HIV patient for a week than it does to provide PrEP for a full year. We are in the midst of a HIV epidemic mainly driven by IV drug use. Making PrEP more available will save lives, save money and provide another point of contact between at risk groups and health professionals. There is literally no downside. Unless for some reason you don’t want to save money or help people at risk of HIV.
@Derek Walsh Ⓥ: taxpayers shouldn’t fund people’s lifestyle, people need to take responsibility for their actions.
@hyippy: IV Not true: IV drug use in Ireland makes up 3% of new HIV diagnoses. Most people get HIV through sex and that’s where PrEP those who need it will benefit
This will be a big mistake and it is going to cause a massive rise in other STD /STI.
I do not understand when people say “it fine I am am clean I am on PREP.
They must be riddled with every other type of infection.
@Sean Ryan: Classic slippery slope fallacy: People who take PrEP test for STIs every three months and take responsibility for their health. There hasn’t been a single study to link PrEP usage to higher overall rates of STIs.
@Will St Leger: how do u know they get tested every 3 month or look after there sexually health ??
Taking PREP and then thinking it ok to having unprotected sex is not taking responsibility
@Sean Ryan: Unless you completely abstain from sex, there’s no such thing as ‘safe sex’. Do you know anyone that uses a condom every single times they give or receive oral sex? even though you can get Chlamydia, Gonorrhea and Syphilis from condomless oral sex? Taking PrEP is safer sex, in the sense that it gives near 100% protection against HIV. How do I know people test every 3 months? I don’t but if they don’t test they don’t get a prescription for PrEP, so there’s an incentive to get follow up checks.
A bit short on detail. The author should site examples of high risk groups. Is it health care professionals for example? It would be nice to know, as the bill to the overburdened taxpayer is already high.
@Martin: if you don’t know this then you have been living in a cave for the last 30 yrs.
@Martin: PrEP is for anyone at risk from HIV. Generic PrEP pill costs less than €1 per pill and should be available to the relatively small number of people who need it (few thousand), whereas one HIV treatment pill costs €49 per day (paid by taxpayer for the rest of that patient’s life) The number of people needing HIV treatment is increase by about 500 people in ireland every year. It’s an economic no-brainer
@Will St Leger: but what about all the other thing you can catch.
Is this not suggesting that HIV is the only danger ??
@Will St Leger: Will, i take your point about prevention being better than the cure and I agree. The article does give dramaticly higher figures suggesting 400 euro a month. Someone has the maths wrong.
@Sean Ryan: Having unprotected sex puts you at risk from STIs including HIV. While I’m not underplaying bacterial STIs like Chlamydia Gonorrhea or Syphilis – they are easily cured by a short course of antibiotics.
HIV on the other hand in lifelong condition which is treatable to the extent that when effective treatment is working and person living with HIV cannot pass on the virus to their sexual partner.
Long story short: No one is going to write a movie or play about Gonorrhea.
People need to remember just because a person who more than likely you have just met for first time says they are on PREP might not be even on it.
@Sean Ryan: In a recent government report on sexual health and attitudes the vast majority of people gay/bi/straight didn’t use a condom with a new or casual partner because quote: “They trusted that the other person didn’t have and STI”
You and you alone are responsible for your sexual health. I don’t take anyone’s word for it.
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