Question
Are people in the UK able to switch to Biktarvy?
27 September 2019. Related: Access to treatment, All topics, Changing treatment.
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.
Hi Kenneth, where are you intending to buy for mentioning Biktarvy is $665? Are you planning to buy in the UK?
HIV treatment in the UK is free of charge. This is regardless of residency status – you do not need a registered address or be known to a GP. How long will you be staying in the UK for? Treatment is accessed from local sexual health clinics. You can find the closest one to where you will be staying here: https://www.bashh.org/clinics
As you will have a supply of treatment with you it can also help if you have your medical notes/history with you. This can help speed up the process of access by informing the doctor of what treatment is suitable for you – Biktarvy is a common combination used in the UK and you should be able to access this.
Iam coming to UK from France for business and iam in need of Biktarvy I was told that the cost was $ 665 per month I can’t afford that in America I belong to positive impact in witch I pay 35$
Please I only have 16 pills leaft is there a substitute for Biktarvy
Thank U