Question
Will the NHS reform affect my current treatment?
24 February 2012. Related: Access to treatment, All topics, Other tests, Side effects.
After today’s Prime Minister’s questions I’m worried about what the changes mean for HIV services and my treatment.
Will I be forced onto the cheapest drugs with more side effects and more pills?
Will regular blood testing for liver and kidney damage be reduced because of the cost?
Will expensive tests like TDM become unavailable?
Answer
Thank-you for your question.
Please could you tell me what it was specifically about Prime Minister’s Questions that worried you?
The NHS reforms should not affect your treatment or access to services. HIV treatment will continue to be provided on the basis of clinical evidence and best practice guidelines. You are unlikely to be asked to change your treatment unless there is a medical reason. You will continue to have access to the same monitoring and testing.
The new draft BHIVA guidelines, as with London prescribing last year, both affirm that treatment is based on how effective it is and how safe. HIV treatment has never been based on the cheapest possible option and this is not going to change in the future. Cost will always be one consideration, but it will never be more important than efficacy and safety.
UK (BHIVA) treatment guidelines give a good guide to a minimum standard for HIV care, use technical medical language. They also include guidelines for monitoring.
Tests to monitor kidney and liver function are not very expensive, especially in relation to the overall cost of treatment. There is no financial pressure to cut these. TDM is also recommended in the guidelines in specific situations and this also should not change.
If you are concerned about how the reforms might affect you then you can discuss this with your doctor. S/he should be able to reassure you that your treatment and care will remain high.
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