Jacky Thorndon
[FYI request #9905 email]
26 April 2019
Dear Jacky,
REQUEST FOR INFORMATION
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
PrEP?
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.
https://www.pharmac.govt.nz/assets/ptac-anti-infective-subcommittee-minutes-2017-12.pdf.
These minutes summarise the available evidence on how effective PrEP is at preventing HIV
infection.
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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https://www.pharmac.govt.nz/seminars/seminar-resources/hiv-update/
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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