PrEP listing brings HIV goal closer

gay couple holding hands

Pre-Exposure Prophylaxis (PrEP) is to be listed on the PBS from 1 April, Health Minister Greg Hunt has announced

The preventative medicine tenofovir disoproxil fumarate with emtricitabine, or Truvada, is for people at medium-to-high risk of HIV infection.

The listing puts Australia in reach of being one of the first countries in the world to end the transmission of HIV, Health Minister Greg Hunt says.

“PrEP is a medical innovation that will save Australian lives and the decision to list it is one of the most significant advancements in HIV transmission Australia has ever seen,” Mr Hunt says.

“The treatment involves taking an anti-retroviral medicine daily to reduce the risk of HIV infection and will now be a key component in our comprehensive commitment in the fight against HIV. 

“The $180 million listing means up to 32,000 patients each year will pay a maximum of only $39.50 per script, with concessional patients paying just $6.40.

“Without subsidy, patients would pay $2,496 per year for this medicine.”

In its recommendation to list the treatment, the Pharmaceutical Benefits Advisory Committee stressed that PrEP should form part of a “comprehensive approach” to sexual health and complement other safe sex practices.

Access to PrEP to date has been “patchy” in Australia, says the Australian Federation of AIDS Organisations, which applauded the decision.

Due to the significant cost, Australian PrEP users mostly accessed it through state and territory trials.

“Having PrEP available at an affordable price through the PBS is a huge advance,” says Darryl O’Donnell, chief executive of the Australian Federation of AIDS Organisations.

“This will drive a substantial reduction in transmission and allow us to turbo-charge the Australian HIV response. This medicine is astoundingly effective and the Australian Government is to be congratulated for being one of the world’s first to make it available through public subsidy.

“This announcement continues Australian leadership on HIV, with Australia having been the first country in the world to commit to a goal of virtually eliminating HIV transmission, by 2020.”

He says stakeholders will now need to ensure all who can benefit from PrEP are aware of its availability and subsidisation so they can consider whether it is right for them.

Dr Darren Russell, Clinical Associate Professor, The University of Melbourne and Adjunct Associate Professor, James Cook University also welcomed the Minister’s decision.

“Despite the significant progress we have made in prevention, diagnosis and treatment of HIV over the last 30 years, around 1000 new cases of HIV continue to be diagnosed in Australia each year,” he says.

“I commend Gilead, who has supported over 130 global TRUVADA for PrEP clinical trials and invested in the medicine’s two Pharmaceutical Benefits Advisory Committee (PBAC) submissions to drive the availability of PrEP in Australia.”

The medicine’s indication for pre-exposure prophylaxis is based on evaluation of its efficacy and safety in two large clinical trials in men who have sex with men (MSM) at high risk for HIV-1 infection, and in heterosexual serodiscordant couples (where one person is HIV positive and the other is HIV negative).

Both studies demonstrated significant risk reduction in the TRUVADA group compared with placebo, says Gilead.

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