PrEP care becomes available to everyone at risk of HIV in the Netherlands

Everyone who is at an increased risk of contracting the human immunodeficiency virus (HIV) will have access to PrEP care from next year, said outgoing Healthcare Minister Ernst Kuipers in a letter to the Tweede Kamer. Currently, only men who have sex with men and transgender people with a higher risk of becoming infected are entitled to care using the HIV prevention medications.

The extended access applies to those who do not belong to the risk groups themselves, but who do have sex with people from that group. The care consists of periodic consultations, examinations and lab work which can be expensive. More healthcare coordination is also needed as the group grows in size. Kuipers said he was going to allocate an additional 1 million euros annually for this, bringing the total budget for PrEP care to more than 7 million euros per year.

"I want PrEP users to pay for their oral PrEP medication themselves within the scheme," Kuipers wrote, at a cost of about 30 euros per month based on daily use. Currently, users pay a contribution of 7.50 euros per 30-day course of treatment.

According to the minister's spokesperson, the Cabinet has now decided to have everyone pay the full amount themselves, so that more money remains for PrEP care for a larger group.

The HIV/AIDS foundation, Aidsfonds - Soa Aids Nederland, said it was happy with Kuipers' proposal, but still finds it problematic that people have to pay for the medication themselves. "If current price levels are maintained, this will not be an obstacle for most people," the organization acknowledged. However, this may change in the future, for example if the cheaper variants are not available due to shortages. The organization believes that all PrEP care and medication should be reimbursed through health insurance, without this being at the expense of the deductible.

On Monday it was announced that the number of new HIV infections has fallen sharply in Amsterdam in recent years. While approximately 200 cases of new infections were detected in 2010, there were only nine last year.