Earlier this week the Health Information and Quality Authority (HIQA) released the long-awaited draft report on their Health Technology Assessment (HTA) of a national PrEP programme for Ireland.
The draft report—which was released as part of a public consultation—affirms what we already knew: PrEP is safe and highly effective at preventing HIV. But it also offered something new and really exciting: a PrEP programme for Ireland would not just be cost-effective, but actually cost-saving.
As HIQA explained in the press release accompanying the draft report: “Providing PrEP is less costly… than not providing PrEP.”
That’s fantastic news, and underscores the clear-cut benefits of getting a functioning PrEP programme up and running without further delay.
The draft report was welcomed by the Government, with the Taoiseach and the Minister for Health both reaffirming their commitment to introducing a national PrEP programme this year—although they provided no specifics about *when* exactly this will happen.
HIQA will be taking public feedback on the draft report until
Which brings us to the less encouraging news in the draft report: an Irish PrEP programme will depend on the already greatly overburdened and underfunded existing public sexual health infrastructure to provide the clinical support needed to use PrEP safely and effectively.
The report is blunt, noting that “The primary barriers to introducing a PrEP programme are staffing and infrastructural issues,” and that “significant investment in STI services is required for a national PrEP programme to ensure a safe, sustainable and holistic service”.
We raised precisely this issue with the Minister when we met with him and officials from the Sexual Health and Crisis Pregnancy Programme and the Department of Health last September. As we emphasised in a follow-up email: “The success of PrEP in Ireland largely depends on the ability of existing sexual health services to deliver it properly… it is vital that there be substantial investment to ensure that that these services can expand their capacity and improve their accessibility.”
This has not yet happened. While a slowly growing number of clinics offer support for PrEP users, the demand still far exceeds the capacity of these clinics—and this demand will grow exponentially when HSE begins to cover the cost of the medication.
With HIV diagnoses at an all-time high in Ireland we desperately need a national PrEP programme that makes PrEP freely available and truly accessible across the country. This HTA draft report contains good news, but it also highlights how much more work remains to be done.
We must keep pressure on the Government and HSE to provide the necessary funding to sexual health services to enable them to support PrEP users, and to do so immediately.
If you’d like to participate in the public consultation you can provide feedback online or download a form here: https://www.hiqa.ie/reports-and-publications/consultation/draft-hta-prep-programme
For information about PrEP for people living in Ireland visit www.getPrEP.online