PrEP trial to be run in Wales despite uncertainty from All Wales Medicines Strategy Group

A Wales-wide study to make the antiretroviral combination treatment Truvada (emtricitabine and tenofovir disoproxil; Gilead Sciences) available for pre-exposure prophylaxis (PrEP) against HIV infection has been announced by Vaughan Gething, Welsh health secretary.

The announcement was made on 28 April 2017, just two days after the All Wales Medicines Strategy Group (AWMSG) concluded that Truvada should not be recommended for NHS use in Wales because its cost effectiveness has not been proven.

Commenting on the three-year study, which will start in summer 2017, Gething says: “There is no doubt that Truvada reduces rates of HIV infection when taken correctly and, supported by wider, preventative sexual health services, can help to reduce overall HIV transmission and infection rates. This is the advice of the World Health Organization.

“The study will help us to learn how best to provide the preventative treatment to reduce the risk of HIV transmission in Wales and answer some of the questions raised by the AWMSG around incidence rates.

“The [AWMSG] is a highly regarded, independent expert group. I acknowledge their advice that there are uncertainties regarding cost-effectiveness… I am asking Public Health Wales and the HIV Expert Group to work together to deliver the study.”

NHS England announced a similar trial in December 2016. In Scotland, however, the NHS use of Truvada for PrEP was approved by the Scottish Medicines Consortium earlier in April 2017.