Cabotegravir is recommended as an option for pre-exposure prophylaxis (PrEP) alongside safer sex practices to reduce the risk of sexually acquired HIV-1 infection in adults and young people at high risk of getting HIV and who weigh at least 35 kg, only if:
they cannot have oral PrEP
cabotegravir is purchased at the Medicines and Procurement Supply Chain framework price.
Cabotegravir is not recommended for PrEP alongside safer sex practices to reduce the risk of sexually acquired HIV-1 infection in adults and young people at high risk of getting HIV and who weigh at least 35 kg, if they can have oral PrEP.
These recommendations are not intended to affect treatment with cabotegravir that was started in the NHS before this guidance was published. People having treatment outside these recommendations may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS healthcare professional consider it appropriate to stop. For young people, this decision should be made jointly by the healthcare professional, the young person and, when appropriate, their parents or carers.
NICE has produced tools and resources to support the implementation of this guidance.
People at high risk of getting HIV can reduce their risk by taking daily PrEP tablets (oral PrEP). But some people cannot have oral PrEP. Cabotegravir is a long-acting injection for PrEP that is used every 2 months, after initiation injections.
Evidence from clinical trials and indirect comparisons suggests that cabotegravir reduces the risk of getting HIV more than oral PrEP or no PrEP.
The cost-effectiveness estimates for cabotegravir are only within the range that NICE considers an acceptable use of NHS resources when compared with no PrEP. So, cabotegravir is only recommended for reducing the risk of HIV-1 infection in people who cannot have oral PrEP.