Decision On Federal Subsidy Of HIV Medication PrEP Postponed


Decision-makers have deferred an approval for HIV prevention medication PrEP to be subsidised on the Pharmaceutical Benefits Scheme, prompting “frustrated” advocates to call for talks to be fast-tracked.

PrEP, short for Pre-Exposure Prophylaxis and also known by its brand name Truvada, is a once-daily pill that has been shown to dramatically reduce the risk of HIV transmission in HIV-negative people at high risk.

On Friday, the Pharmaceutical Benefits Advisory Committee (PBAC) released minutes from its July meeting where it made a “deferral” decision on whether PrEP should be subsidised on the Pharmaceutical Benefits Scheme (PBS). A listing on the PBS would reduce the cost of the pills to no more than $38.80. Without one, it remains too expensive for most people.

Pharmaceutical companies Mylan and Gilead Sciences both brought applications for PrEP to the July PBAC meeting. The Committee didn’t reject them, but deferred its decision as it conducts price negotiations and seeks further information on the number of people likely to use it. According to the minutes, PBAC acknowledge the effectiveness of PrEP but are concerned about the medication’s cost.

HIV/AIDS organisations, including the Queensland AIDS Council, have called on the drug companies and PBAC to enter negotiations immediately to resolve the outstanding issues around the medication.

“Given PrEP is so effective at preventing HIV transmission, people will be disappointed and deeply frustrated at this outcome,” Australian Federation of AIDS Organisations CEO Darryl O’Donnell said.

“HIV will be needlessly transmitted while we wait for equitable and affordable access to PrEP.”

He said without the equitable access to PrEP, Australia’s target of ending HIV transmission by 2020 won’t be reached.

“With Truvada now off patent, there’s no reason PBAC shouldn’t be able to negotiate a fair and reasonable price,” he said.

“The drug companies need to be realistic about the price they charge and PBAC needs to marshal all the information available to support the PBS listing of PrEP.”

The Therapeutic Goods Administration approved the medication for use by at-risk HIV-negative people in May last year.

Ahead of the federal budget in May, health minister Greg Hunt committed to funding any new medicines recommended by PBAC.

Experts say the deferral highlights the importance of PrEP trials in several – but not all – Australian states and territories, which are still recruiting people at risk of HIV transmission and providing them with free PrEP medication.

Places are still available in Queensland’s QPrEPd study, and eligible Queenslanders are encouraged to sign up at one of the project’s sites around the state.

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