June was an exciting month for us here at PSS as we were approached by BBC journalist Linzi Kinghorn to discuss, and be involved in, a news piece highlighting the postcode lottery situation with Xonvea here in the UK. We were delighted to have the opportunity to help raise awareness of an issue we have been campaigning about for more than 18 months, both behind the scenes and through discussions with ICBs across the UK.
Xonvea, a combination of Doxylamine and Pyridoxine, was introduced to the UK in 2018 as a drug specifically indicated for treating nausea and vomiting in pregnancy. It remains the only licensed antiemetic for this purpose in the UK, having been formally reviewed and approved by the MHRA (Medicines and Healthcare products Regulatory Agency). Despite its relatively new status here in the UK, this combination of medication has been used around the world for decades. Although Xonvea has now been available in the UK for several years, its availability remains complicated. As awareness of the medication grew, it became increasingly apparent to us at Pregnancy Sickness Support that access was a problem. We heard overwhelmingly positive feedback from people who had been able to try Xonvea, yet many more contacted us to say they had been refused it as a treatment option. This sparked a campaign here at the charity to help improve access to Xonvea across the UK, driven by a passion to improve care and equality of access to treatment for pregnant women.
We spent much of last year engaging with ICBs (Integrated Care Boards) across the UK to better understand why Xonvea is still not available as a treatment option for everyone. For now, the decision as to whether Xonvea is available on local prescribing lists is made by each individual ICB. Responses were mixed, and progress was made – but cost is still an issue. At £28.50 for a box of tablets (around one week’s supply) it’s deemed just too expensive in some areas and as a result women do not have equal access to try it if they would like to. This feels short-sighted, particularly when considering the wider impact of untreated HG, including repeated GP appointments, hospital admissions, time away from work and the long-term effects on women and their families.
Linzi Kinghorn identified this issue and wanted to raise awareness, and she filmed a news segment featuring a case study with a patient who had struggled to access Xonvea during her pregnancy, along with an interview with Professor Catherine Nelson-Piercy and myself. Between us we were able to discuss key issues surrounding Xonvea – from a patient perspective, a healthcare professional perspective and my own – somewhere in the middle. Every day, we hear from women whose pregnancies are affected by limited access to Xonvea. While ICBs must balance a range of financial and clinical considerations, it’s important that the lived experiences of patients and the wider impact of untreated pregnancy sickness are also taken into account.
In line with the television piece, which was broadcast on BBC South News on Monday 29th June, there was also a news article published: Why is pregnancy sickness drug not easily accessible to all? – BBC News and I was also invited to speak on the BBC Solent Radio breakfast show.
We continue to hope that this situation will resolve. The renewed Womens Health Strategy that was released this year stated that we will move towards a single national formulary within the next two years and we hope that Xonvea will be included. Until then, we will continue to advocate for equitable access to evidence-based treatment, so that where someone lives no longer determines the care they receive during pregnancy.
