Q and A

Question

Are people in the UK able to switch to Biktarvy?

Hi, I asked my clinic to switch to Biktarvy (I’m London-based), but I wasn’t allowed by my consultant.

Is this the same across England or are some trusts allowing patients to switch to Biktarvy?

And what about Scotland and Wales?

I am in my early 30s and Biktarvy seems to offer a better toxicity profile than my current Tivicay (dolutegravir) and Truvada (tenofovir+FTC) regime.

Answer

Hi

Thanks for your question.

Biktarvy will be available wherever you live if you need this drug, but there are guidelines for how this new combination is prescribed.

Scotland, Wales, Northern Ireland and the four regions of England all commission HIV services independently. So this does mean that access to treatment across the UK does sometimes vary. But HIV care doesn’t usually have big differences though and the NHS guidelines for how drugs are used are very similar.

It sounds like you maybe don’t meet these criteria to be able to access this now. For example, it is recommended for people who for medical reasons either need to use tenofovir alafenamide (TAF) or are not able to use alternative combinations. This is linked to higher price for Biktarvy compared to similar combinations that are just as effective.

The guidelines for using new drugs in England are linked to this page:
https://www.england.nhs.uk/commissioning/spec-services/npc-crg/blood-and-infection-group-f/f03

The documents for Biktarvy (including evidence review and gudielines) are here:
https://www.england.nhs.uk/commissioning/publication/bictegravir-emtricitabine-tenofovir-alafenamide-for-the-treatment-of-hiv-1-in-adults

The studies comparing Biktarvy (bictegravir/TAF/FTC) to dolutegravir (Tivicay) and Truvada (TDF/FTC) showed both combinations produced equally good results. Some aspects of the side effects – for example cholesterol and lipids – were better for people using dolutegravir/TDF/FTC.

Even though your treatment choice is a factor in your care, the NHS doesn’t include the right to choose medicines when these cost more than equally effective combinations that are less expensive.

HIV care in the UK is based on your individual history and medical need so this might be the likely reason your doctor wouldn’t prescribe this.

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