On 11 September, NHS England issued a policy statement for a single tablet, four-in-one HIV combination treatment called Stribild (also know as Quad). [1]
This is important as the first new HIV treatment to be reviewed under the new NHS structure for commissioning HIV care.
The commissioning position, effective from August 2013, states the following scenarios in which it will be routinely funded:
- In ARV experienced patients with no prior history of virological failure or drug resistance, and who require a switch from their current regimen where there is a clinical advantage of Stribild over alternative switch options and where the use of the individual components is not contraindicated.
OR
- In ARV-naïve patients with high viral loads who are not suitable for NNRTIs (or others on NNRTI who need to switch for reasons unrelated to resistance).
AND
- Where the decision to prescribe Stribild has been taken after review in a Multidisciplinary HIV specialist treatment meeting and that this will be subject to clinical and commissioner audit.
AND
- Where Stribild prescribing is no greater than 5% of the patients in a clinical cohort on treatment.
The combination was approved by the US FDA in December 2012 and by the EMA in May 2013. [2, 3]
