{"id":54565,"date":"2026-08-28T07:20:09","date_gmt":"2026-08-28T07:20:09","guid":{"rendered":"https:\/\/i-base.info\/htb\/?p=54565"},"modified":"2026-08-29T10:18:51","modified_gmt":"2026-08-29T10:18:51","slug":"nhs-approves-lenacapavir-treatment-in-england","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/54565","title":{"rendered":"NHS England finally approves lenacapavir for ART"},"content":{"rendered":"<div  class=\"wp-caption alignnone\"><a href=\"https:\/\/i-base.info\/htb\/wp-content\/uploads\/2026\/08\/ACT-UP-lenacapavir-demo-1-of-1-scaled.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-54568\" class=\"wp-image-54568 size-large\" src=\"https:\/\/i-base.info\/htb\/wp-content\/uploads\/2026\/08\/ACT-UP-lenacapavir-demo-1-of-1-1024x531.png\" alt=\"\" width=\"620\" height=\"322\" srcset=\"https:\/\/i-base.info\/htb\/wp-content\/uploads\/2026\/08\/ACT-UP-lenacapavir-demo-1-of-1-1024x531.png 1024w, https:\/\/i-base.info\/htb\/wp-content\/uploads\/2026\/08\/ACT-UP-lenacapavir-demo-1-of-1-300x156.png 300w, https:\/\/i-base.info\/htb\/wp-content\/uploads\/2026\/08\/ACT-UP-lenacapavir-demo-1-of-1-768x398.png 768w, https:\/\/i-base.info\/htb\/wp-content\/uploads\/2026\/08\/ACT-UP-lenacapavir-demo-1-of-1-1536x797.png 1536w, https:\/\/i-base.info\/htb\/wp-content\/uploads\/2026\/08\/ACT-UP-lenacapavir-demo-1-of-1-2048x1063.png 2048w\" sizes=\"auto, (max-width: 620px) 100vw, 620px\" \/><\/a><p id=\"caption-attachment-54568\" class=\"wp-caption-text\">Community activists demonstrate the urgency of access to lenacapavir, February 2026<\/p><\/div>\n<p><strong>Simon Collins, HIV i-Base<\/strong><\/p>\n<p><strong>After years of protracted discussions between NHS England and Gilead, long-acting lenacapavir injections will finally be routinely available as a life-saving drug.<\/strong><\/p>\n<p>The indication is for people who are unable to construct an active combination due to either multi-drug resistance (MDR) or intolerance to other drugs. These limited circumstances are only expected to initially affect about 100 people.<\/p>\n<p>The 45-page evidence review is also posted online. [2]<\/p>\n<p>Inclusion criteria<\/p>\n<ul>\n<li>Adults aged 18 years and over.<\/li>\n<li>Weight &gt;35 kgs.<\/li>\n<li>MDR HIV-1 infection and are either:<br \/>&nbsp;<br \/>\n(i) not virally suppressed with existing ART regimen<br \/>&nbsp;<br \/>\nOR<br \/>&nbsp;<br \/>\n(ii) are virally suppressed but on a highly complex regimen with concerns of tolerance, resistance or safety where the addition of lenacapavir could simplify the regimen and optimise individuals\u2019 outcome and experience.<\/li>\n<\/ul>\n<p>They must also meet all the following criteria:<\/p>\n<ul>\n<li>Individuals have limited or no therapeutic options remaining.<br \/>&nbsp;<br \/>AND<\/li>\n<li>The use of lenacapavir has been discussed and agreed with the individual or individual\u2019s representative and the HIV specialist MDT.<br \/>&nbsp;<br \/>AND<\/li>\n<li>The individual or individual\u2019s representative is able to agree to the required injection schedule.<br \/>&nbsp;<br \/>AND<\/li>\n<li>Lenacapavir is to be added to an optimised background ART regimen.<\/li>\n<\/ul>\n<p>Please see full document for full details.<\/p>\n<h3>comment<\/h3>\n<p><strong>Lenacapavir was approved by the MHRA in 2022 as a treatment for MDR-HIV and the delay by NHS England for access to a life-saving drug with expected low use and a relatively low price is shocking.<\/strong><\/p>\n<p><strong>Immediately after approval, Gilead established a free named-patient access programme but after three years with no outcome, this programme was closed to new participants in April 2025. NHS Scotland agreed a price and approved lenacapavir in April 2025.<\/strong><\/p>\n<p><strong>HIV community advocates should not have to hold street protests for such medicines &#8211; although ACT-UP London, BHIVA, the UK-CAB, cliniQ, Sophia Forum, NAT, i-Base and numerous HIV organisations did this as part of an access campaign earlier this year.<\/strong><\/p>\n<p><strong>As with all approvals for new drugs to treat MDR-HIV, it is important that the indication \u00a0for lenacapavir includes use to achieve viral suppression that isn\u2019t possible with current ART.<\/strong><\/p>\n<p><strong>One of the benefits of long-acting injections is to support people who for complex reasons have adherence difficulties that risks developing further drug resistance.<\/strong><\/p>\n<p><strong>For example, several independent research groups, including in the US, have achieved viral suppression, often for the first time, by using 6-monthly lenacapavir in combination with CAB-LA, in the setting of NNRTI-resistance. [4]<\/strong><\/p>\n<p>References<\/p>\n<ol>\n<li>NHS England. Lenacapavir for multi-drug resistant Human Immunodeficiency Virus 1 infection (HIV-1) (adults) [URN: 2344]. Clinical Commissioning Policy. Reference number: 2344. (16 July 2026).<br \/>\n<a href=\"https:\/\/www.england.nhs.uk\/publication\/clinical-commissioning-policy-lenacapavir-for-multi-drug-resistant-human-immunodeficiency-virus-1-infection-adults\/\">https:\/\/www.england.nhs.uk\/publication\/clinical-commissioning-policy-lenacapavir-for-multi-drug-resistant-human-immunodeficiency-virus-1-infection-adults\/<\/a> (web page)<br \/>\n<a href=\"https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2026\/07\/2344-commissioning-policy-lenacapavir-for-hiv.pdf\">https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2026\/07\/2344-commissioning-policy-lenacapavir-for-hiv.pdf<\/a> (PDF file)<\/li>\n<li>NHS England. Evidence review. (45 pages). (16 July 2026).<br \/>\n<a href=\"https:\/\/www.england.nhs.uk\/publication\/clinical-commissioning-policy-lenacapavir-for-multi-drug-resistant-human-immunodeficiency-virus-1-infection-adults\/\">https:\/\/www.england.nhs.uk\/publication\/clinical-commissioning-policy-lenacapavir-for-multi-drug-resistant-human-immunodeficiency-virus-1-infection-adults\/<\/a><\/li>\n<li>Lenacapavir EAP in the UK closed to new referrals: NHS England and Gilead fail to agree a price after more than two years. HTB (20 April 2025).<br \/>\n<a href=\"https:\/\/i-base.info\/htb\/50940\">https:\/\/i-base.info\/htb\/50940<\/a><\/li>\n<li>Gandhi M et al. Case Series of People With HIV on the Long-Acting Combination of Lenacapavir and Cabotegravir: Call for a Trial. Open Forum Infect Dis. 2024 Apr 16;11(4):ofae125. doi: 10.1093\/ofid\/ofae125.<br \/>\n<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/38628952\/\">https:\/\/pubmed.ncbi.nlm.nih.gov\/38628952<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Simon Collins, HIV i-Base After years of protracted discussions between NHS England and Gilead, long-acting lenacapavir injections will finally be routinely available as a life-saving drug. The indication is for people who are unable to construct an active combination due &hellip;<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,38,44],"tags":[],"class_list":["post-54565","post","type-post","status-publish","format-standard","hentry","category-antiretrovirals","category-treatment-access","category-womens-health"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/54565","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=54565"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/54565\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=54565"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=54565"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=54565"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}