Colm Brophy
Question:539. Deputy Colm Brophy asked the Minister for Health the estimated cost of increasing funding to the HIV PrEP programme by 10%. [45932/24]
View answerThursday, 7 November 2024
Questions (539)
Written answers
A national HIV pre-exposure prophylaxis (PrEP) programme commenced in November 2019, following a HIQA HTA, which concluded that its introduction would be safe, effective, and cost saving.
Free PrEP medication is available to individuals who meet clinical eligibility criteria, attending HSE approved PrEP services. These include public PrEP services, delivered through the public network of STI clinics, and some general practice (GP) services and private providers. There are currently 13 approved public PrEP services, located in public STI clinics, and 17 private or general practitioner (GP) PrEP providers. Appointments at the 13 public PrEP services are free of charge, however, the private providers charge for consultations.
The number of people eligible to access PrEP has been expanding since inception, with the number of individuals re-imbursed for PrEP at least once expanding from 1763 in 2020 (the first full year of service delivery), to 3388 in 2022 and 3802 by the end of Q4, 2023.
Clinical criteria for PrEP eligibility have been widened in recent years, increasing the number of people eligible for the programme. While the PrEP service continued to grow in 2023, many PrEP services are reaching (or have reached) capacity and service users are reporting challenges accessing appointments. By the start of Q4, 2024, 6,070 individuals were approved for free PrEP medication. Additional work is required to understand the extent of the unmet need/demand for PrEP, which has been estimated as circa 30%.
In order to expand these services and provide additional supports to our rapidly growing population, we have been allocated additional funding of €600,000, through Budget 2025, to further support delivery of the PrEP scheme, bringing the total allocation to €5.9m. This additional funding is comprised of €0.2m for additional PrEP drug costs, and €0.4m for additional staffing in the public STI clinics from July 2025, increasing capacity for in-person appointments. The additional allocation comprises approximately 11.5% of the 2024 PrEP budget.
Furthermore, the home STI testing scheme is being used to support the PrEP programme; an additional €0.6m has been allocated to support this, given increasing demand for the service. This brings funding for home STI testing to €4.82m in 2025.
In order to increase capacity, a number of additional measures have been deployed and are being developed, including administrative efficiencies, the use of telephone consultations and use of the free home STI testing scheme for routine tests. In order to increase the number of providers, a PrEP competency framework and eLearning platform has been developed; these can be accessed by GPs with an interest in providing PrEP.
It is of vital importance that people at risk of HIV and living with HIV (PLHIV) are promptly linked to care, for prevention of onward transmission and for clinical benefit. It is also vital that those at risk are encouraged to access regular testing and preventive programmes such as PrEP. These measures are key elements towards achieving UN and WHO aims of ending the HIV/AIDS epidemic in Europe by 2030 and supporting wider national and international commitments.
In addition to further funding for both PrEP and for home STI testing in 2024, we are progressing further development of HIV Fast-Track Cities in Dublin, Cork, Limerick and Galway. We are also supporting people living with HIV and countering the stigma they may experience.
Additional capacity for PrEP delivery, through the public system, its partnerships and through primary care, are being considered as part of the wider ongoing work to redraft the National Sexual Health Strategy, which is almost complete. Measures included for consideration will include a Model of Care for sexual health, to examine capacity and delivery, nationwide, in the context of HIV and STI rates that are rising both nationally and internationally.
As PrEP capacity is a service matter, I have also asked the Health Service Executive to respond to the deputy directly, as soon as possible.