OIA Response: PrEP Data

Request for information relating to PrEP (emtricitabine with tenofovir), which is Pre-Exposure Prophylaxis. PrEP is a daily pill for people who do not have HIV to prevent HIV.

[Name and email redacted]

26 April 2019

Dear [Name redacted],

REQUEST FOR INFORMATION

Thank you for your request dated 22 March 2019 under the Official Information Act 1982 (OIA) for information relating to PrEP (emtricitabine with tenofovir), which is Pre-Exposure Prophylaxis. PrEP is a daily pill for people who do not have HIV, to prevent HIV. 

You asked:

  1. Is PHARMAC aware of cases where people using PrEP contract HIV?
  2. Was PHARMAC aware of any cases where people using PrEP contracting HIV when deciding to make it available?
  3. What information is PHARMAC providing doctors to support their patients using PrEP?
  4. Is PHARMAC monitoring such cases and will you work with Medsafe to help users of PrEP be safe?

In relation to your first question, PHARMAC does not hold information on whether people using PrEP have contracted HIV and so is not aware of specific cases where this has occurred. The Ministry of Health may be able to identify whether patients who have had PrEP have then gone onto a regimen for HIV treatment – which could indicate that they had contracted HIV while using PrEP.  I have passed your question on to the Ministry of Health as they are the more appropriate agency to answer it. Our normal process would be to send you a formal notification of the transfer of your question, but this was missed. I sincerely apologise for that.

In relation to your second question, PHARMAC sought expert clinical advice on PrEP before making the decision to fund. You can find meeting minutes of the Anti-infective Subcommittee of the Pharmaceutical and Therapeutics Advisory Committee on our website.

These minutes summarise the available evidence on how effective PrEP is at preventing HIV infection.

In relation to your third question, you asked what information PHARMAC is providing to doctors to support their patients using PrEP. We recently commissioned an article through Best Practice Advocacy Centre, which provided an HIV update and a ’How-to guide’(external link) on prescribing PrEP. PHARMAC hosted a sexual health seminar in September 2018 for GPs and included in this was a presentation on PrEP from Dr Massimo Giola. These presentations are provided for professional development purposes for the benefit of qualified health practitioners and should not be relied upon for any other purpose. You can find this seminar and other HIV related seminars on our website.

In relation to your fourth question, PHARMAC set the requirements for funding of PrEP to ensure funding is targeted to those people who will benefit the most. The requirements include ongoing monitoring and testing of people taking PrEP. Details of these requirements and more information about our decision to fund can be found in our website notification.

PHARMAC staff are continuing to work with the Ministry of Health Sexual and Reproductive Health, Systems Outcomes team regarding monitoring of best practice and outcomes. Medsafe (part of the Ministry of Health) is responsible for medicine safety and efficacy.

If you have any further questions, please feel free to contact us again.

Yours sincerely

[Alison Hill's signature]

Alison Hill
Director, Engagement and Implementation