LONDON – The state health service in England has the legal power to fund an HIV pill to prevent infection, the court of appeal ruled on Thursday, in a victory for AIDS campaigners who have been calling for its widespread use.
But it is still unclear whether the state system will have the financial resources to make the drug widely available.
So-called pre-exposure prophylaxis (PrEP) against HIV can cut the risk of getting the virus during sex by more than 90 percent, according to clinical studies.
NHS (National Health Service) England had argued it was not in a position to fund the medicine because PrEP was a preventative service and therefore the responsibility of local authorities.
The NHS lost that argument in an initial court case in August, prompting the appeal.
"We are delighted to have been vindicated by the court a second time," said Deborah Gold, chief executive of the National Aids Trust (NAT), which brought the case.
The NAT argues that PrEP is a potential game-changer and is urgently needed in Britain, where more than 4,000 people acquire HIV annually.
NHS England said it would now formally consider whether to fund PrEP. It noted that the court ruling established that the NHS has the ability but not the obligation to pay for the medicine.
Gilead Sciences' Truvada is currently the only drug approved in Europe for PrEP, although several generic companies in India make cut-price versions of the product.
The original Gilead drug costs around 400 pounds ($500) for a month's supply and its unavailability on the state health service has prompted some people to turn to online "buyers clubs" to get cheaper copies delivered from India.
NHS England said it would ask Gilead to reconsider its current "excessively high pricing" and would also explore options for using generics.
"We expect to be able to update on these developments shortly," it said in a statement.
Gilead had no immediate comment.
Use of PrEP is rising fast in the United States, where tens of thousands of people are now taking it to prevent infection. It is also being rolled out in other parts of Europe.
Truvada is a combination of two antiretroviral drugs that work to keep HIV, which causes AIDS, from replicating in the body.
(Editing by Jane Merriman)