Anger after NHS warns PrEP HIV drug could put other treatments at risk

A warning from NHS England that it cannot confirm funding for drugs to treat rare conditions including cystic fibrosis in children if it is to pay for an HIV prevention pill has been criticised by Aids campaigners.

The high court ruled on Wednesday that NHS England can fund pre-exposure prophylaxis (PrEP), a medication that cuts the risk of HIV infection by almost 90% and is aimed particularly at men who have unprotected sex with multiple male partners.

NHS chiefs immediately said they would appeal against the decision and warned that if the health service is to be responsible for providing the HIV therapy, at a cost of £10m-£20m a year, it may not fund other treatments.

As well as a cystic fibrosis drug for children, eight other treatments would be under threat of having funding cut, according to the NHS, including stem cell transplants for a rare blood cancer and a prosthetic knee for amputees.

Related: Users of HIV prevention PrEP urge NHS to fund ‘life-changing’ medicine

Drugs for rare conditions are categorised by price and effectiveness, from level one to five. The NHS statement said: “Given the ruling, NHS England cannot confirm funding for those treatments and services in levels three and four.” It did not name specific conditions.

Deborah Gold, the chief executive of the National Aids Trust (NAT), told the Times the statement was “deeply unhelpful”.

She said: “NHS England press releases now appear to be pitting PrEP against other treatments. Had NHS England not unlawfully pulled PrEP from its decision-making process in March, all prioritised new policies and drugs would now already be funded.”

Other treatments at risk of losing funding include a drug to prevent low sodium levels in the blood of chemotherapy patients, a childhood narcolepsy treatment and brain implants for children with hearing problems.

The NAT brought the high court case following anger and consternation among campaigners after NHS England said it would not fund PrEP because it did not have the power to do so. It argued that it was the role of local authorities, which have been given control of public health measures including reducing smoking and family planning as well as HIV prevention. Local authorities said they did not have the money to pay.

Mr Justice Green in the high court said NHS England had erred and that both it and the local authorities were able to fund the drugs if they so chose.

“No one doubts that preventative medicine makes powerful sense,” he said in his judgment. “But one governmental body says it has no power to provide the service and the local authorities say that they have no money.

“The clamant [the National Aids Trust] is caught between the two and the potential victims of this disagreement are those who will contract HIV/Aids but who would not were the preventative policy to be fully implemented.”

Gold said it was “enormously disappointing” that NHS England had decided to appeal against the ruling.

Anger after NHS warns PrEP HIV drug could put other treatments at risk