HIQA begins health technology assessment of HIV PrEP programme

PrEP is a form of HIV prevention whereby HIV medications (most commonly two antiretrovirals used in combination: tenofovir and emtricitabine) are taken by HIV-negative individuals to prevent infection. The World Health Organisation (WHO) recommends that PrEP containing tenofovir should be offered as part of HIV prevention programmes to people at substantial risk of HIV infection.

HIQA’s Director of Health Technology Assessment and Deputy Chief Executive, Dr Máirín Ryan, said: “HIV infection remains a significant public health concern. In 2017, over 500 new HIV infections were reported to the Health Protection Surveillance Centre (HPSC) in Ireland. In fact, the years 2016 and 2017 witnessed the highest number of new HIV notifications ever reported to the HPSC. Approximately half of all new notifications were in males who have sex with males (MSM). Since 2006, there has been a threefold increase in new infections in the MSM community.”

Dr Ryan continued: “HIQA’s assessment will look at the clinical- and cost-effectiveness of funding a PrEP programme. In addition to providing PrEP free-of-charge, such a programme would also monitor patients through regular testing and provide counselling and advice. The assessment will also look at the budget impact of introducing a PrEP programme and assess the organisational and resource implications of such a service.”

HIQA is establishing an expert advisory group comprising representatives from key stakeholder groups who will advise the HTA evaluation team during the course of this assessment.

Minister for Health Simon Harris has committed to rolling out the PrEP programme in 2019.

HIQA’s work is due to conclude by early next year and the Minister said he looks forward to advancing policy on this issue at that juncture.

“We know that enormous progress has been made in the treatment of people living with HIV,” said Minister Harris. “However, we are also acutely aware of the significant numbers of people in Ireland being diagnosed. Prevention is absolutely essential and as Minister for Health I am keen to make PrEP, which is a prevention tool, more readily available to those at risk of HIV in Ireland.”

Between 865 and 2,683 individuals would avail of HIV PrEP in the first year of roll-out, the HSE has estimated.