Effects of PrEP: 80% decline in new HIV infections in the Dean St Clinic

wordofwarning

Dean St Clinic is Europe's largest STI clinics and it is in Soho, London. They have just reported a 80% decline in new HIV infections for the first 9 months of 2017 versus the first 9 months of 2015. This is mainly due to people ordering PrEP online.

http://www.pinknews.co.uk/2017/10/06/80-fall-in-new-hiv-diagnoses-at-europes-largest-sexual-health-clinic/

It is a pity regulatory bodies here would not use common sense and see the benefits of PrEP. Rather than seizing it for 'safety concerns'. Safety concerns that they will not validate

https://www.irishtimes.com/news/health/customs-seizing-large-amounts-of-anti-hiv-drug-being-ordered-online-1.3171783

The Dean St Clinic has tested hundreds of patients on generic PrEP ordered online and has yet to find a single case of unauthentic generic PrEP. They have stopped testing people to see whether or not PrEP is actually authentic, as they are no longer concerned about it being being authentic.

Ten of Swords

Damn that graph, you can see an immediate improvement from Sept 15. Difficult to argue with that,



I can see where customs and regulators are coming from through with regards to posting medicines from abroad into Ireland, legitimate or not, so probably not fair to lay the blame at their feet. Gilead Science have filed lawsuits against any company that tries to produce a generic alternative, most recently Pharma giant Mylan Pharmaceuticals. There is a major infringement suit ongoing in the US and injunctions have been filed in Dublin too.

Irish Times (July 2017)

GCN (October 2017)

wordofwarning

Ten of Swords wrote: »

I can see where customs and regulators are coming from through with regards to posting medicines from abroad into Ireland, legitimate or not, so probably not fair to lay the blame at their feet.

I would agree until Dean St Clinic tested something like 270 people on PrEP and found not a single case of it being inauthentic. You have to say that is a very shocking stat and supportive of the idea that is in fact safe to order PrEP online. The fact there is a 80% decline in HIV rates, also shows the PrEP is authentic. There is nothing to suggest that PrEP ordered online is in fact unsafe

The HPRA told the Irish Times, they have not tested whether or not the PrEP being seized was genuine or not. Why? It is because it will likely come back as authentic based on what the Dean St Clinic have found in their patients ordering PrEP online. IMO it is unacceptable to be seizing packages just because you don't like the look of them

Lawsuits filed by Gilead further strengthen the notion, that we need to allow people to import their own PrEP. Cheap generic PrEP may not be in the EU for another 5 years. We can't just let people get HIV while we wait for the patient to expire

Ten of Swords

wordofwarning wrote: »

I would agree until Dean St Clinic tested something like 270 people on PrEP and found not a single case of it being inauthentic. You have to say that is a very shocking stat and supportive of the idea that is in fact safe to order PrEP online. The fact there is a 80% decline in HIV rates, also shows the PrEP is authentic. There is nothing to suggest that PrEP ordered online is in fact unsafe

I don't doubt it, It's probably not a stretch to suggest that all (certainly the overwhelming majority) of the pills seized were completely genuine but it will simply not be legal to order prescription medication on the internet from anywhere in the world (with or without the supervision of a doctor - how would the retailer know) and customs are enforcing that. I'm not talking just about Truvada I'm talking about any medication (legal or otherwise). I get exactly what you're saying and in this specific situation ordering from markets outside Ireland would be a viable alternative but as a process it just wouldn't work, way too open to abuse.

The GCN link in post 2 reports that Gilead has threatened the HSE with a lawsuit if they sourced a generic alternative, this indicates their hands are effectively tied too. Great news if you're a GS shareholder, not so good for literally everyone else. This July article mentions Dean clinic.

GCN (July 2017)

wordofwarning

Ten of Swords wrote: »

I get exactly what you're saying and in this specific situation ordering from markets outside Ireland would be a viable alternative but as a process it just wouldn't work, way too open to abuse.

Obtaining medicine outside of Ireland is the only alternative. "Way too open to abuse", yet there is a not a single case of the system being abused in the UK in terms of PrEP medicine. The HSE/Customs/the HPRA, should warn you about the dangers of medicine and the nanny state involvement should end there. We can prevent hundreds getting HIV or we can protect them from medicine that has been proven to be nothing but safe and authentic. At what stage, does the state 'protecting' you, actually cause you more harm?

The fact is nearly all PrEP is coming from a handful of sites, that are heavily vetted and monitored. It is not that difficult to find out if that generic Mylan PrEP you bought is authentic or not.

Ten of Swords wrote: »

The GCN link in post 2 reports that Gilead has threatened the HSE with a lawsuit if they sourced a generic alternative, this indicates their hands are effectively tied too. Great news if you're a GS shareholder, not so good for literally everyone else. This July article mentions Dean clinic.

GCN (July 2017)

The NHS put 10,000 men on a 'trial' which allows them to use generic medicine. If there is a will, there is a way.

Ten of Swords

There is a European agency called EAMSP (European Association of Mail Service Pharmacies) that allows the purchase of prescription medications over the internet or phone. Ten countries in Europe are members of this agency, including the UK. Sadly Ireland is not one of them.

If it was then it would be much easier and safer to obtain (although cost saving may be negligible).

I agree with what you have said and it's very frustrating that Ireland has adopted this position