Question
How much do HIV drugs cost in the UK?
2 August 2021. Related: Access to treatment, All topics.
Hi, hope much do HIV meds cost in the UK. Does this mean I am just given the cheapest drugs?
Answer
Hi
Thanks for your question.
Drug pricing in the UK is complicated because the prices paid by the NHS are never made public. Also, different regions in the UK negotiate different prices with different companies.
This can make the actual price much lower than the price listed in the British National Formulary (BNF).
The graphic in Table 1 shows the relative costs for commonly used combinations when starting ART. This is from the Midlands and East of England region.
Cost is never the most important factor for deciding treatment. Even the most expensive combinations are very cost effective. Every doctor can prescribe every HIV drug when this is the best treatment for a particular patient.
Cost becomes important when several options are appropriate for an individual. In this case, NHS prescribing is based on using the least expensive one first.
If someone has problems with side effects, switching to an alternative drug should always be easy in the UK.
Similar tables are available for switching treatment. These can be seen in this detailed document from the same NHS region.
Source: Midlands & East Region: Antiretroviral Therapy (ART) Prescribing Implementation Guidance for Adult and Adolescent Patients Starting and Switching Treatment 2021-2022. (July 2021 update). This replaces all previous versions. Full document.
This answer has a lot more details about cost and access:
https://i-base.info/qa/14152
Note: This graphic in this answer was updated in August 2021 from a question posted in Feb 2018.
Hi David, thanks for sharing your experience and I am sorry you have had such a difficult and stressful time.
If you had contacted i-Base earlier we would have recommended that you contact one ot the larger HIV clinics close to where you are staying and they would have been able to help. This would have been much easier. General pharmacies in the UK are rarely able to provide HIV meds because these drugs are commissioned and distributed through HIV clinics.
The UK and US have very different health systems and someone visiting the US from here would also find things very different, with similar difficulties. Although France also has public healtyhcare like the UK, there are differences again.
One difference is that your US clinic only providing you with a month of meds at a time involves so much bureaucracy and inconvenience even if you are not travelling. Problems with repeating scripts and difference insurance providers often means people risk interrupting treatment even if they are not travelling. Once on stable meds, most countries (including many programmes in African countries) now provide 3-6 months of meds at a time, especially after the difficulties of COVID.
If your lowest ever CD4 count in the past was ever less than about 200, your CD4 count could easily havedropped during your timie off treatment.
It is good that you have now sorted replacement meds and I hope that the rest of your trip goes well.
I can speak to the difficulty, even impossibility, I faced trying to fill an ART prescription in England in 2022 as a visiting U.S. citizen. (I can’t speak of Scotland, where I understand law may govern prescriptions differently). My family spent January through April 2022 in the Midlands. Then we spent May in France. We had obtained UK visas. My husband was teaching. His UK college had a contract with a local surgery for our medical consults. I attempted to take a five month supply of Biktarvy with me but Blue Cross insurance gave me a run-around so I left with just a month supply —thinking I’d just pay whatever necessary in the UK. In January I presented my home physician’s Rx for Biktarvy at two different major pharmacies. Both politely said Biktarvy is not available in the UK and I should consult a physician for another med. Ok, saw a physician who prescribed Genvoya. For me on my VISA, I learned the cost would be £1800 for a 30 day supply. I made a calculated decision to stop therapy for February through May. A few weeks before my end of April departure from the UK I developed oral thrush. I got a prescription to zap it. The doc downplayed my voiced concern that it was a certain sign of runaway HIV. Then the weekend before my departure from the Midlands I developed excruciating neural pain first in my hands, but then also in my arms that prevented me from sleeping and left me moaning in pain. I launched an urgent campaign to obtain Genvoya at any cost. The small city pharmacy I consulted didn’t carry it. The pharmacist said he’d have to order and my cost would be £1800. I went to London, where I spent several days trying to obtain Genvoya with no success. I prepaid £1800 on my charge card to a pharmacy in Mortlake, in southwest London, where the staff said they’d order from a manufacturer across town. Long story short, in a week it never came, and the pharmacy refunded my payment. I gave up, and decided to try in France. (If that should fail, my plan C was to fly home to the US where a refill was waiting for me.) (Meds emphatically cannot be mailed. Believe me, I tried.) I took the Eurostar from St Pancras to Gare du Nord. I walked into the first pharmacy I found, Pharmacie Centrale du Nord at 132 rue La Fayette, and presented a UK prescription. The pharmacist pulled out Genvoya from a nearby shelf and sold it to me for €690.