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A leading HIV charity has urged immediate action to enable community pharmacies to supply HIV prevention medication pre-exposure prophylaxis (PrEP).
A report published by the Terrence Higgins Trust (THT) on 1 January 2026 has called for community pharmacies to “help close the gaps in access” to the medication, particularly for people living in more rural areas and those who may not access sexual health centres.
Deborah Gold, former chief executive of the National AIDS Trust and author of the report, said: “We already know that PrEP works and that it is highly cost-effective. What this report shows is that the way PrEP is currently delivered is leaving too many people behind.
“Community pharmacies are trusted, accessible and embedded in communities. With the right policy changes, they could play a transformative role in HIV prevention and help close the gaps in access that persist today.”
Currently, pharmacies can dispense PrEP against a prescription or under a patient group direction (PGD). However, because they cannot access stock procured by NHS England, they must purchase the medication at a much higher cost than is available to secondary care providers and sexual health clinics.
“The difference between these two costs is so significant that it has acted as a barrier to commissioning PrEP services in community pharmacy,” the THT report suggested, adding that “NHS England should urgently review its current position”.
The report also highlighted that pharmacies have access to centrally procured stock through other services such as contraception and COVID-19 vaccinations.
Alongside this, “work should begin immediately to agree an appropriate commissioning model” for PrEP supply through community pharmacies — either a national NHS England programme, a locally commissioned programme or a hybrid of the two, the report recommended.
It also set out several potential pathways for community pharmacy involvement in PrEP delivery, including dispensing and continuation monitoring.
As an immediate next step, the report urged local authorities to explore commissioning community pharmacies to refer into existing pathways.
It said that local authorities, the British Association for Sexual Health and HIV (BASHH), NHS England and the Department of Health and Social Care (DHSC) should work together with Community Pharmacy England to design a PrEP pathway that allows initiation of PrEP and all consequent activities.
Commenting on the report, Henry Gregg, chief executive of the National Pharmacy Association, said it made sense for pharmacies to provide PrEP vaccinations.
“Pharmacies already provide vaccinations to patients for flu and COVID-19, making them more accessible and increasing uptake among groups who are less likely to get vaccinated.
“Convenient and based on people’s doorsteps, pharmacies make it quick and easy for people to protect themselves and their loved ones.
“With the right funding, it makes sense for the government to also use pharmacies for PrEP vaccinations, helping those who need it the most get protection they need from this life changing illness.”
PrEP has been routinely available from specialist sexual health services in the UK since 2020. However, plans to increase access in England have been in discussion since the publication of ‘Towards zero: the HIV action plan for England — 2022 to 2025‘ in December 2021.
The ‘PrEP access and equity task and finish group’ — established by the DHSC in October 2022 to identify ways of improving access to PrEP, as part of the HIV action plan — recommended the establishment of a series of national pilots for PrEP provision in settings outside specialist sexual health clinics, including pharmacies.
A pilot service in the south west of England ran from October 2024 until spring 2025, the results and recommendations of which were published in September 2025.
In December 2024, the Welsh government said that it was considering trialling PrEP provision through community pharmacy.
In October 2025, the National Institute for Health and Care Excellence recommended the HIV prevention injection cabotegravir (Apretude; ViiV Healthcare) for people unable to take oral PrEP.
Read more: ‘Why is HIV pre-exposure prophylaxis struggling to find a home in UK primary healthcare?’
