The Terrence Higgins Trust has called on the government to make pre-exposure prophylaxis (PrEP) available through community pharmacies in England.
In a new report published last week (January 1), the charity said expanding access to PrEP into community pharmacies “would be a practical and powerful step towards” achieving the government’s ambition to end new HIV cases by 2030.
And it added that “enabling trained community pharmacists to provide PrEP would significantly widen access, reduce health inequalities, and ease pressure on overstretched sexual health clinics”.
Game-changer
While PrEP is mostly accessed through sexual health services, the charity said “many people at risk of HIV either cannot or will not attend clinics due to stigma, distance, inflexible opening hours or competing responsibilities”.
It added that “community pharmacies, which are widely used, locally based, and open for longer hours, could offer a more convenient and discreet route”.
Making PrEP available in pharmacies “could be a game-changer for rural gay and bisexual men and Black communities across the country”, it said.
Read more: Pharmacy PrEP’s absence from HIV action plan ‘regrettable’
The report sets out a number of recommendations for the government, NHS England and local authorities, including:
- Allowing community pharmacies to access PrEP via existing national medicines procurement systems
- Developing a national patient group direction (PGD) to enable community pharmacists to dispense PrEP
- “Immediately” agreeing a sustainable commissioning and payment model for pharmacies
Read more: Pharmacies ‘should be at heart’ of HIV prevention, researchers say
The report highlighted that while community pharmacies must purchase the medication they dispense from a wholesaler, sexual health clinics and secondary care providers - which can access stock procured by the NHS - face “very significantly” lower costs for generic PrEP.
It added that “the difference between these two costs is so significant that it has acted as a barrier to commissioning PrEP services in community pharmacy”.
NHS England “should urgently review its current position” and grant community pharmacies access to PrEP via centrally procured stock, it said.
Transformative
Deborah Gold, author of the report, said it shows that “the way PrEP is currently delivered is leaving too many people behind”.
“Community pharmacies are trusted, accessible and embedded in communities,” she added, and “with the right policy changes, they could play a transformative role in HIV prevention and help close the gaps in access that persist today”.
Terrence Higgins Trust chief executive Richard Angell said England “has made huge progress on HIV” but “won’t reach zero new cases unless we radically widen access to PrEP”.
Read more: Welsh government reveals plans for pharmacy PrEP pilot
“Ministers and NHS leaders must now act on these recommendations so that PrEP is available in the places people already go for care,” he added.
National Pharmacy Association (NPA) chief executive Henry Gregg described the report as “important” and said that pharmacies “make it quick and easy for people to protect themselves and their loved ones”.
“With the right funding, it makes sense for the government to also use pharmacies for PrEP vaccinations, helping those who need it the most get protection they need from this life-changing illness,” he added.
Read more: ‘Tear down the regs and make PrEP readily available’, say MPs
It comes after former pharmacy minister Steve Brine last month told C+D that the government’s decision not to include access to PrEP via pharmacies in its new HIV action plan was “regrettable”.
And in September, a pilot by researchers at the University of Bristol found that community pharmacies “could transform access” to PrEP by offering a “more accessible and discreet alternative” to sexual health clinics.
