Hmm haven't read up on it so forgive my ignorance, but how many people are you actually going to help with this?
People who have safe sex now are already "safe" so if a load of people switch to prep then you're incurring a greater cost (and I'm guessing this is a rather large cost) for the same effect. If, as I suspect, prep isn't as effective as condoms then potentially you have greater expense and a slightly higher infection rate.
Lazy people who have unprotected sex now probably aren't going to remember to take their medication so what's the point?
Wreckless people who like danger are by definition not safe, you can't "fix" that.
Shirley the only demographic you're going to have a meaningful effect on are those who know the risks but think the feeling of condom free sex is worth the risk but are conscientious enough to take their meds. How many people are we talking about? A lot? I've no idea. Is it even possible to get honest enough answers to find out that number?
Shirley the only demographic you're going to have a meaningful effect on are those who know the risks but think the feeling of condom free sex is worth the risk but are conscientious enough to take their meds.
....or the heterosexual partners of people who're HIV positive but find themselves unable to have children?
Sure it'll mean something to someone in that position.
Don't know if folk are aware but people like myself who have an Exemption Card (cos my condition is on the list) we're able to get any other meds free of charge even if they're not related to the condition.Think of the savings that could be made there!
Sorry, just re-read and that's what you've said. Nurse - I need my meds!
I could have been clearer 🙂
It has always surprised me that all my medication is free, not just the stuff I need. I'm fairly healthy other than the crap pancreas so haven't really used the card for anything else.
I was a bit surprised at a friend who was pro NHS but openly admitted trying to get medication for her husband on her free prescription card which just seem a bit double standard to me. I think they've cracked down on checking the cards more recently because of things like that.
Getting rid of the cards and just making certain medications free would possibly save.
not a use I was aware/had thought of, thanks. However I was merely wondering about general numbers not specific cases or suggesting who should/shouldn't get access to it.or the heterosexual partners of people who're HIV positive but find themselves unable to have children?
But it is limited to a specific number of treatments, after that you have to go private.
It is still 'lifestyle' (the desire to have a child). It isn't to cure a disease. In that case it is similar.
I guess contraception too should be banned based on this. Do people have to go private to get the pill?
It's all a bit of a mess this 'free' NHS stuff though. I pay for my glasses and eye test. I pay for my dentist. All are more 'essential' than the item we are discussing now.
If we are into this preventative thing, can we all get a free NHS helmet, knee and elbow pads for mtbing?
PJM1974 - MemberGay Men demographically are higher risk so a lot of the focus will go that way.
Forgive me if I'm leaping to a conclusion, but I read the crux of your argument is to withhold Prep and rely on fear alone to prevent gay men from getting pissed up and having risky sex with one another?
It's a bit like withholding contraception from teenagers in case they get tempted for a bit of rumpo?
Oh no, quite the opposite.
I noted some posters were keen to point out that HIV isn't just a 'Gay thing' and we shouldn't start thinking HIV is a problem for other people (providing you're straight or female), but at the same time we have to remember PREP is a preventative drug and at the moment an expensive one one so it will have to be a limited resource, to make the most of the resource it will be used in a very focused way.
HIV is more prevalent with Gay/Bi men than any other demographic so it should be 'promoted' towards them and needle users other high-risk people will also be likely be given it on a case by case basis. Uninfected partners of HIV carriers etc, rather than just prescribed carte blanche to anyone who asks for it.
The other way to look at it, would be that if it was supplied cart blanche around the world, it probably could/would eradicate the disease.
Also is the price a true reflection of the research and production costs, or is it an exploitation of the market. There are things far more important than freemarket ideology.
this isn't vaccination tho is it? AIUI you have to have a good supply and be conscientious enough to take it daily, so realistically (I'd have thought) that unless you start putting it in the water supply everywhere you're not going to get the herd* immunity needed to eradicate hiv.The other way to look at it, would be that if it was supplied cart blanche around the world, it probably could/would eradicate the disease
also what are the side effects? Sounds like some nausea and vomiting short term, long term? Eradicating hiv will take some time, maybe a generation or two?
*admittedly the herd in this case is only the parts of the population that are sexually active, needle sharers or some other transfer vector, so dunno if the usual rules apply.
i've read a little more on prep since yesterday but still much so feel free to point out if I'm talking cobblers.
HIV is more prevalent with Gay/Bi men than any other demographic so it should be 'promoted' towards them and needle users other high-risk people will also be likely be given it on a case by case basis.
Ah! Apologies for misconstruing your point.
I can't argue with your logic, in fact that makes perfect sense to target risk groups and offer Prep to them.
Surely just comes down to cost benefit ratio. Is the cash best spent on this measure or others.
, NHS England is holding in readiness funding to cover PrEP – but has warned that this will come at the expense of funding some other specialised services provisionally identified as priorities by the NHS England Clinical Priorities Advisory Group, such as prosthetics for lower limb loss and ivacaftor (Kalydeco) for children (2 to 5) with cystic fibrosis.
http://www.aidsmap.com/High-Court-rules-NHS-England-is-responsible-for-funding-PrEP/page/3076337/
As to it's cost effectiveness
whether PrEP in the UK will be cost-effective or not depends on what one thinks is likely to happen. Will it gradually be taken up, initially by the gay men at the highest risk of HIV infection and then in time, by lower-risk gay men and other people such as at-risk heterosexuals? Or will there be mass adoption of PrEP from the start? In the latter scenario PrEP would be unaffordable without immediate substantial reductions in drug cost. In the former it may even save money, as long as the expected future falls in drug prices keep pace with increased numbers on PrEP.
irc - MemberSurely just comes down to cost benefit ratio. Is the cash best spent on this measure or others.
Well, that's all the financial argument comes down to. But that's not the only decision when you're dealing with healthcare. (cost/benefit ratio for my diabetes is terrible, I was only 7 when I was diagnosed so it'd have made more sense to put me down and grow a new one)
For.
The NHS should be doing more preventative care. In the western world in general we do far far too much "wait for something to go wrong and then treat" when we should be doing far far more intervention and education.
