This is an HTML version of an attachment to the Official Information request 'People using PrEP contracting HIV'.

Jacky Thorndon
[FYI request #9905 email]
26 April 2019
Dear Jacky,
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 
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 
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’ 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.
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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
Director, Engagement and Implementation
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