England’s NHS Again Refuses to Back PrEP
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It doesn't surprise me at all.
The NHS in all parts of the UK discriminate against men in all parts of medicine. As an example, guys get cancer from HPV x5 more than girls, yet for the longest time, only girls got the vaccine. Even now that it's been approved for guys, it's nearly impossible for a guy to get the vaccine.
HPV hides in the folds of the genitals of both genders, yet they only suggest that boys be circumcised to protect girls, despite the fact that circumcising girls would benefit guys who are more likely get it.
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It might not be great but its still 100% better than what we have in the USA.
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It might not be great but its still 100% better than what we have in the USA.
It's not hard to beat the USA when it comes to healthcare accessibility. Even third world countries do.
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I wonder what the cash price of Truvada is in the UK.
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I'm not sure about the price in the UK, but I know that the price in Canada at the cheaper independent pharmacies is around $1050 for a 30-day supply. I know this largely because I used to be on it after I was first diagnosed.
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Raphjd is correct in that the NHS assumes that everybody is straight and once a doctor or nurse has assumed it, it can be embarrassing to correct them such as my lesbian friend who had to explain why it was not possible for her to get pregnant or myself when having a sexual health checkup having to tell them they were asking me the wrong questions! They work on the fact that the majority of the population is straight and the fact that somebody could be other never even enters into their head for consideration.
The issue of prep however is not as scandalous as gay media makes it out.
It's not at all that surprising when you think that the NHS is socially funded and still has to pay the manufacturer the same kind of cost to buy it and that the NHS only charges the end user a flat rate contribution £8.40 per month (approx 10USD).
The NHS do not see it as viable because it only protects against HIV and not other STIs which are much more prevalent in the UK (and drug resistant = more expensive drugs need to be bought to combat those). The NHS gives out condoms and liquid silk lubricant absolutely free to everybody to prevent all sexual diseases including HIV - branded condoms such as Durex, Mates, Pasante even the xl sizes and textured ones. They do however provide Post Exposure for people who have been diagnosed as positive because they need the medication.
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It is available in the UK through the private healthcare system who will provide you with more choice of drugs for conditions and what you want rather then need.
- You need to make a private appointment at the GP (you need to pay for his time)
- You then need to pay for a private prescription to be written out once they decide you might benefit
- You need to travel to a specialist pharmacy (high street pharmacies will not stock it) or buy it online
Truvada is on average £400per month ($490 US / $650 CA) and generic is £44 ($55US / $72 CA) per month
info on obtaining it through private health insurance supplied by : http://www.iwantprepnow.co.uk/prep-on-the-nhs
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Long story short is, it is available just not as cheap as some people would like it.
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Raphjd is correct in that the NHS assumes that everybody is straight and once a doctor or nurse has assumed it, it can be embarrassing to correct them such as my lesbian friend who had to explain why it was not possible for her to get pregnant or myself when having a sexual health checkup having to tell them they were asking me the wrong questions! They work on the fact that the majority of the population is straight and the fact that somebody could be other never even enters into their head for consideration.
Edit: Thought I pressed Modify must have pressed quote instead can a mod merge and delete
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The part about not backing PrEP due to the fact that it does not protect against other STI's is rather insane if you ask me. Other STI's do not kill you if untreated or otherwise possibly become life threatening… HIV on the other hand does.... So to me, this whole part about not wanting to cover it because it only protects against HIV in my opinion is a piss poor and pathetic excuse.
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They don't see it as "cost effective" because the manufacturer states that it needs to be used with condoms which they already give out for free. Say for example gay men make 10% of the population and you multiple it for £400 for Truvada and by 12 for an annual figure.
63,182,000 divided by 10 = 6318200 x 400 x 12 = £30,327,360,000 per year extra just for that additional one drug to be provided. Which only protects against 1 disease and isn't guaranteed to actually work as we have had cases of people contracting HIV despite being on the drugs. Then you have to look at the cost of them getting more expensive drugs for other STIs which are becoming drug resistant.
It is possible to get prep if you want it privately as I said in my post but don't expect to get it taxpayer subsidised through the NHS.
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1. Gay men don't make up 10% of the UK population
2. Even if they did, they wouldn't all be on PrEP. The target population is more or less sexual active single or non-monogamous gay adult men, trans women, sex workers and those in serodiscordant relationships. It would be generous to say that together they make up 3% of the population.
3. If cost is a concern then the NHS could easily choose to purchase £44/month generic PrEP assuming they wouldn't be able to negotiate a much better bulk rate.If they really wanted to, NHS could find some money to pay for this out of their £116.4 billion budget
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1. The often quoted number is 10% . The British Treasury estimated 6% and Stonewall estimates 5 - 7% and this study says 6.5% reported an option other then "straight" leaves us with 4.5 million
https://www.theguardian.com/politics/reality-check/2013/oct/03/gay-britain-what-do-statistics-say
3. That budget sounds high but it really isn't when it has to run an entire countries entire health system where they are increasingly selling parts of it off to private corporations because they can't afford to run it.
Also you have these public cases
https://www.poz.com/article/meet-man-got-hiv-daily-prep
https://www.poz.com/article/second-man-contracts-rare-hiv-strain-apparently-adhering-prep
So the drug isn't working to prevent HIV in people are are taking it properly. Its pissing money down the drain because its not working as a preventative.
Also the side effects are nasty:
http://angryhomosexual.com/truvada-prep-side-effect-disaster/
Permanent Liver and Pancreas Damage … That needs a lifetime of care also has to be paid for by NHS.
The drug company tells you that you must still use condoms whilst on this medication so you might as well just carry on using condoms. As said above it is possible to get this drug if you want it through private health insurance or pay for it outright.
The only people I would seriously consider needing this on the NHS are those in a sero-discordant relationship.
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So the drug isn't working to prevent HIV in people are are taking it properly. Its pissing money down the drain because its not working as a preventative.
In both cases, and that's exactly two people out of 30,000+ taking PrEP in the US, the people who got infected contracted rare strains of the virus that are resistant to Truvada. It would be one thing if such strains were common but they aren't it would be a miraculous if the failure rate for condoms were as low as it is for Truvada. Pretending that it is infective because it is not invincible is not just dishonest. It's dangerous.
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And strains that are resistant will become more commonplace. Viruses mutate in order to get around these drugs - its part of the reason why the NHS is not prescribing as many antibiotics as they used to because diseases were becoming immune to the drugs being used to treat it.
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I'm not sure about the price in the UK, but I know that the price in Canada at the cheaper independent pharmacies is around $1050 for a 30-day supply. I know this largely because I used to be on it after I was first diagnosed.
Interesting. I have a HIV+ friend who was on Truvada and another drug early in his diagnosis. I agree with those who say the side effects are scary (including possible facial wasting, which isn't so pretty)(most…all? ARVs can have bad side effects), but I also agree with you that it is fucking insane for the NHS not to provide PrEP.
Treating HIV is not cheap. And that's cold hearted economics, and not ethics. Truvada as PrEP works! The studious person in me is concerned about viral mutation and therefor resistance, and truly bad side effects which someone whom is HIV- might not want to expose themselves to.
I'm HIV-, practice safer sex, but I'm on an SSRI anti-depressant. I'm young, but I'm "married" to Cialis to get a full erection. 30 20mg pills is anywhere from $750-$1650, and no insurance covers that.
Hence my wonderment about what people in the UK pay when they see a private Dr. and get on PrEP.
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Hence my wonderment about what people in the UK pay when they see a private Dr. and get on PrEP.
Truvada is on average £400per month ($490 US / $650 CA) and generic is £44 ($55US / $72 CA) per month
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Hence my wonderment about what people in the UK pay when they see a private Dr. and get on PrEP.
Truvada is on average £400per month ($490 US / $650 CA) and generic is £44 ($55US / $72 CA) per month
So that's cheaper –- by half --- than the cash price in the USA. Shameful on the US.
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If it was available on the NHS it would be about 10$ a month
