NHS England has today launched a 45-day public consultation on a proposed clinical commissioning policy on Pre-Exposure Prophylaxis (PrEP) for HIV.

The organisation has concluded that there is sufficient evidence to support a proposal for routine commissioning of the service for specific sub groups of adults at high risk of HIV acquisition.

It says there has already been "extensive engagement" on this policy, which has been developed with the support and input of lead clinicians and patient and public representatives, and that the consultation is being run without prejudice to the outcome of an appeal following a judicial review.

NHS England is currently appealing a recent High Court decision that it does actually have the legal power to commission the PrEP service because, it argues, the service, being a preventative measures, falls under the remit of local authorities.

The draft commissioning policy has been published for consultation pending a ruling from the Court of Appeal, so that a system can be put in place as quickly as possible once a final decision is reached, NHS England said.

However, it also stressed that "this does not imply that PrEP - at what could be a cost of £10-20 million a year - would actually succeed as a candidate for funding when ranked against other candidate interventions in this year's annual specialised commissioning prioritisation round, but it is a necessary condition for such an assessment to take place".

Recent evidence indicates that the PrEP approach can be highly effective in preventing transmission of the disease as long as the drugs are taken regularly; data from the pilot phase of the PROUD study show that PrEP using Truvada cut the incidence of HIV infection by 86 percent.

The once-daily pill costs around £360 a month, according to the AIDS charity the Terrence Higgins Trust, but it points out that this is still cheaper than the cost of treating HIV, which has been estimated at around £360,000 over a life-time.