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New study indicates national PrEP programme would be cost effective

The Lancet Infectious Diseases publish scholarly study into the HIV prevention treatment, PrEP titled, Cost-effectiveness of pre-exposure prophylaxis for HIV prevention in men who have sex with men in the UK: a modelling study and health economic evaluation.

The study indicates a UK-wide PrEP programme would be cost-effective, and could prevent up to one in four cases of HIV.

In the UK, HIV incidence among men who have sex with men (MSM) has remained high for several years, despite widespread use of antiretroviral therapy and high rates of virological suppression.

Pre-exposure prophylaxis (PrEP) has been shown to be highly effective in preventing further infections in MSM, but its cost-effectiveness has been uncertain.

In this modelling study and economic evaluation, researchers calibrated a dynamic, individual-based stochastic model, the HIV Synthesis Model, to multiple data sources (surveillance data provided by Public Health England and data from a large, nationally representative survey, Natsal-3) on HIV among MSM in the UK.

They did a probabilistic sensitivity analysis (sampling 22 key parameters) along with a range of univariate sensitivity analyses to evaluate the introduction of a PrEP programme with sexual event-based use of emtricitabine and tenofovir for MSM who had condomless anal sexual intercourse in the previous 3 months, a negative HIV test at baseline, and a negative HIV test in the preceding year.

The main model outcomes were the number of HIV infections, quality-adjusted life-years (QALYs), and costs.

The study finds the introduction of such a PrEP programme, with around 4,000 MSM initiated on PrEP by the end of the first year and almost 40,000 by the end of the 15th year, would result in a total cost saving (£1·0 billion discounted); avert 25% of HIV infections (42% of which would be directly because of PrEP), and lead to a gain of 40,000 discounted QALYs over an 80-year time period.

This result was particularly sensitive to the time period chosen, the cost of antiretroviral drugs (for treatment and PrEP), and the underlying trend in condomless sex.

The study findings suggest that the introduction of a PrEP programme for MSM in the UK is cost-effective and possibly cost-saving in the long-term. A reduction in the cost of antiretroviral drugs (including the drugs used for PrEP) would substantially shorten the time for cost savings to be realised.

Dr Michael Brady
Dr Michael Brady

Dr Michael Brady, Medical Director at Terrence Higgins Trust, said: “One of the key arguments against PrEP has been that it will cost the NHS too much money. This study firmly puts that claim to bed by demonstrating that, when appropriately targeted at those at risk of HIV, it is not only highly cost-effective but, as the price of HIV drugs falls, will actually save the NHS money in the long run. Each HIV infection we prevent saves the NHS £360,000 of a lifetime of treatment and care.

“The study also highlights the importance of cheaper, generic versions of PrEP, which are currently being used in NHS England’s PrEP Impact trial and have been commissioned for PrEP use in Scotland.

“This cost effectiveness data underlines the importance of PrEP in the fight against HIV. It is not only highly clinically effective it is also cost-effective. The NHS England Impact trial, which will provide access to PrEP for 10,000 people over the next 3 years, is a welcome step in the right direction. However, it is important that all who need PrEP can access it and evidence like this reinforces the need for PrEP to be fully commissioned and given a long-term, sustainable home on the NHS in England.”

Barnardo’s successful at Pink News Awards

Barnardo’s won an award for improving LGBT+ equality at the Pink News Awards in Westminster last night.

The UK’s leading children’s charity received the Third Sector Equality Award at the ceremony which celebrates the contributions of politicians, businesses, campaigners and community groups to improving LGBT+ life in the UK.

It fought off competition from the National Theatre, Tate Galleries, St Mungo’s, Amnesty International and the National Union of Students.

Javed Khan
Javed Khan

Barnardo’s Chief Executive, Javed Khan, said: “We’re thrilled to win this award and delighted to have our work in improving LGBT+ equality recognised.  Having a workforce that is inclusive of our LGBT+ staff and volunteers is essential if we are to fully understand and meet the needs of LGBT+ children and young people.

“Barnardo’s champions equality, diversity and inclusion and helps young people to be themselves and raises wider awareness about LGBT+ issues so they can also be supported by their peers.”

The judges were impressed how Barnardo’s puts equality and inclusion at the heart of all its work, from the way it supports children and young people to who works or volunteers for the charity. Building a diverse Barnardo’s is a core part of its ten-year corporate strategy.

The charity actively works to create a workforce that is inclusive of LGBT+ staff and volunteers in order to understand and respond to the needs of LGBT+ young people and to increase LGBT+ awareness.

Barnardo’s led campaigning for LGBT+ fostering and adoption and for around 20 years has helped many children to thrive in loving, safe family environments.

Its wide range of services to support LGBT+ young people includes the Positive Identities service that supports young people struggling with sexual orientation and gender identities. Its Department of Education-funded anti-bullying training programme challenges the attitudes and behaviour in schools, families, faith and wider communities towards LGBT+ people.

Safezone training has made Barnardo’s and its services welcoming places for LGBT+ people and  has been rolled out to GP practices, health services, youth services and schools.

For full list of awards, click here:

Could you be a short term foster parent for a disabled child?

Barnardo’s Brighton and Hove Link Plus provides high quality fostering and short breaks for disabled children and their families.

They are desperately looking for more carers from all sectors of the community who can offer anything from occasional overnight stays through to full-time fostering for children aged 0-18.

If you have a love for children, a sense of humour, time, energy and patience, you could help to make a huge difference to disabled children and their families.

It is a rewarding role and short breaks give disabled children and young people the day-to-day opportunity to be just children.

For their parents, a short break can go a long way in helping them to re-charge their batteries or spend time with their other children.

A parent says:a small amount of time can give a lot of fun which is hard to always give when there are other pressures of life, work and family.” 

If you have the time and energy to support a local disabled child and their family, we would love to hear from you. We have been working in Brighton and Hove since 1988 and OFSTED have judged us to be Outstanding.

All applicants will undergo an assessment process and ongoing support, training and supervision is provided. People will need to have a spare room and an allowance is paid.

For more information or an informal chat contact Vicky Lloyd or Lisa Giles on 01273 295179 or email: vicky.lloyd@barnardos.org.uk or lisa.giles@barnardos.org.uk

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