Pharmac is overhauling its criteria for prescriptions to an effective safe sex drug common to gay men.
Pre-exposure prophylaxis (PrEP) Photo: 123rf
From 1 July, 2022, the criteria for funded access to pre-exposure prophylaxis (PrEP) will change to the patient being at risk of, but tests negative for, HIV and their doctor thinking it is "clinically appropriate" for them.
The drug can reduce the risk of being infected with HIV by up to 99 percent and prescriptions are funded for some people in New Zealand.
Burnett Foundation Aotearoa (formerly the New Zealand Aids Foundation) chief executive Joe Rich said it was "very exciting".
It was "particularly great for people at high risk of HIV" because it removed "very specific" criteria like patients being required to have had unprotected receptive anal intercourse with a casual partner in the previous three months, he said.
It was a "great step" towards the Foundation's goal of local transmission of HIV reaching zero by 2025, noting rates were already heading in the right direction, he said.
Burnett Foundation Aotearoa chief executive Joe Rich Photo: RNZ / Jake McKee
HIV peer support organisation Body Positive executive director Mark Fisher agreed.
"[Pharmac's changes] makes PrEP available to everybody who may benefit from it and it takes away from that whole stigma around PrEP."
That stigma was people being uncomfortable asking for the drug because the criteria meant they had to talk about, and detail, their sex life with their doctor, he said.
He hoped it would increase usage of the drug from about 1600 current patients. Pharmac estimated it would increase to 5500 users in the next five years.
The new criteria was proposed in May after the drug-buying agency received a $191 million boost in Budget 2022.
File photo: Body Positive executive director Mark Fisher Photo: Supplied
Fisher and Rich both pointed out the sudden pace at which Pharmac made the change, given in April Pharmac indicated to RNZ, which had reported on the tight criteria for months, that change was still months away as it was still reviewing a smaller proposal from 2020.
Fisher said it was making New Zealand "world leaders" in the LGBTQIA+ health space because it was more broad, including allowing sex workers and at-risk women eligible for funded prescriptions.
Rich was "just happy that it's happened" but had hoped "it would've happened before now".
Pharmac director of operations Lisa Williams, acknowledging the quick turnaround since the proposal, said there was "overwhelming support" for the proposal during its public consultation period.
She stressed the change did not mean people could just get the drug by asking for it and would still need to speak to doctors about the risks of HIV and exposure.
Dr Peter Saxton, one of the country's top sexual health researchers, said the next step was for health providers to "dramatically improve the quality of sexual health and Rainbow-affirming care in Aotearoa".
He highlighted this in his submission on the proposal by using unpublished data from the Sex and Prevention of Transmission Study, which is currently underway.
The data included comments about a nurse saying "how all gay and bisexual men should stop being promiscuous" when someone mentioned wanting to be on PrEP, a GP telling another person "it was disgusting" and they "should just use a condom", and others feeling judged.
Other funding changes made by Pharmac include a widening access to post-exposure prophylaxis (PEP), a course of medication within 72 hours of exposure to HIV, as well as blood and breast cancer medicines, and widening access to eight multiple sclerosis treatments.