Safe sex advocates want the pre-exposure prophylaxis (PrEP) HIV prevention drug made more accessible after Pharmac announced it will drop its price by almost 75 percent.
A bottle of "PrEP" ( Pre-exposure prophylaxis) tablets used to prevent HIV. Photo: 123rf
PrEP can reduce the risk of being infected with HIV by up to 99 percent and is funded for some people in New Zealand.
It currently costs $61.15 for a 30-day supply, but following Pharmac's annual tender it will reduce to $15.45 from July 2022.
One of the requirements to receive a funded PrEP prescription is that the patient must have had unprotected receptive anal intercourse with a casual partner in the previous three months.
HIV peer support organisation Body Positive's executive director Mark Fisher said the price drop was a sign PrEP accessibility should be reassessed, particularly because the cost/benefit analysis for the criteria was developed in 2018 when a 30-day supply of the drug cost about $900.
He said PrEP should be accessible to "anybody who needs it or could potentially benefit from [it]", because the cost of treating someone infected with HIV spans their lifetime and was "a lot more expensive than PrEP now will be ... some of those drugs are $1000 a month".
Although the drug price was dropping, Fisher said other related costs meant PrEP would remain "a little bit expensive" for those ineligible for a funded prescription.
"There are too many barriers in place and what happens is people give up, and they don't bother, and that's what puts them at risk."
Similarly, the University of Auckland's Dr Peter Saxton, one of the country's top sexual health researchers, said "staying on PrEP is more difficult for some and is patterned by inequities".
He said research had shown PrEP use in New Zealand was lower than it should be but also that HIV transmission in a community declined when PrEP use rose.
"Price shouldn't be a barrier to HIV prevention in Aotearoa. Everyone has a right to the HIV prevention choice that makes sense for them, and that includes PrEP."
Fisher wanted to see Pharmac make changes to the criteria in alignment with the price change in July.
"What they need to do is take advantage of the tool we know that's effective."
Pharmac's Anti-Infective Subcommittee endorsed changes to the prescription criteria in September 2020 but no changes have been made yet.
The drug-buying agency is still conducting an internal review of the implications of widened PrEP access, which then needs to go out for consultation.
Pharmac's chief medical officer Dr David Hughes said the Anti-Infective Subcommittee were intending on looking at further widened access options in their next meeting, which is in June.
Consultation would then have to happen on the back of that meeting "if we decided to progress with any widened access proposal".
Hughes said the price drop was because of a change in suppliers and that cost savings are not necessarily re-invested into the same area.