William Eichler 02 August 2016

Councils welcome ruling that NHS can fund new HIV drug

The High Court has ruled the NHS is able to fund new HIV drug despite objections from health professionals.

Council chiefs have long argued funding the pre-exposure prophylaxis (PrEP) drug, which has been shown to reduce the risk of HIV infection by more than 90%, fell within the remit of NHS England.

The Local Government Association (LGA) argued that as NHS England has retained responsibility for the commissioning of HIV therapeutics, councils should not be forced to cover the cost of this treatment.

An LGA spokesperson said last June: ‘During the transition period to the implementation of the NHS and Care Act 2010, NHS England sought to retain commissioning of HIV therapeutics, which the PrEP treatment clearly falls into.

‘It is, and should remain, an NHS responsibility unless it is fully funded for local authorities to pass on.’

However, the national health service argued they did not have the legal power to commission the new medication as it is up to local authorities to fund HIV prevention services.

The High Court judge has ruled that there is nothing stopping the NHS from paying for the drug, a decision the LGA's community wellbeing portfolio holder, Cllr Izzi Seccombe, welcomed.

‘We are pleased that today’s ruling confirms our position that NHS England has the power to commission the HIV treatment PrEP,’ she said.

‘We firmly rejected the argument by the NHS that it should fall to councils. We argued that NHS England was wrong in law and that its power includes commissioning for preventative purposes, such as HIV-related drugs.’

The NHS has said it will appeal the judgement because it feels the court’s ruling is ‘inconsistent with Parliament’s intention’ with regards to legislation governing the health services role and function.

Dr Jonathan Fielden, NHS England’s director of specialised commissioning and deputy national medical director, said: ‘Queen’s Counsel has advised NHS England that it should seek to appeal against the conclusions reached by the judge as to the scope of NHS England’s legal powers under the National Health Service Act 2006.

‘In parallel with that we will set the ball rolling on consulting on PrEP so as to enable it to be assessed as part of the prioritisation round.’

Dr Fielden stressed the decision does not mean PrEP will automatically be funded by the NHS.

‘Of course, this does not imply that PrEP – at what could be a cost of £10-20m a year – would actually succeed as a candidate for funding when ranked against other interventions,’ he said.

‘But in those circumstances, Gilead – the pharmaceutical company marketing the PREP drug Truvada – will be asked to submit better prices, which would clearly affect the likelihood that their drug could be commissioned.’

Commenting on the high court ruling, Liberal Democrat health spokesperson Norman Lamb said: ‘The Liberal Democrats warmly welcome the Court’s decision, which is a landmark moment in the fight against HIV.

‘PrEP is a revolutionary treatment which has the potential to save thousands of lives, and it is absolutely right that this should be funded by NHS England.’

‘I am now urging the Government and NHS England to work together to ensure that PrEP is made available to all individuals at the highest risk of infection without any further delay,’ he added.

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