Pre-Exposure Prophylaxis Program for MSM Cost-Effective in UK
This result was sensitive to the time horizon, the cost of treatment and PrEP antiretroviral drugs, and trends in condomless sex.
HealthDay News — Introduction of an HIV pre-exposure prophylaxis (PrEP) program for men who have sex with men (MSM) in the United Kingdom is likely to be cost-effective, according to a study published online in the The Lancet Infectious Diseases.
Valentina Cambiano, PhD, from University College London, and colleagues conducted a modeling study and economic evaluation, calibrating a dynamic, individual-based stochastic model to multiple data sources on HIV among MSM. Analyses were conducted to evaluate introduction of a PrEP program with sexual event-based use of emtricitabine and tenofovir for MSM who had engaged in condomless anal sexual intercourse in the previous 3 months and were HIV-negative at baseline.
The researchers found that introduction of a PrEP program, with about 4000 and 40,000 MSM initiated on PrEP by the end of the first year and the 15th year, respectively, would be cost-saving (£1 billion discounted), prevent 25% of HIV infections (42% directly related to PrEP), and lead to 40,000 discounted quality-adjusted life years gained over an 80-year time horizon. This result was sensitive to the time horizon, the cost of treatment and PrEP antiretroviral drugs, and trends in condomless sex.
"This analysis suggests that the introduction of a PrEP program for MSM in the United Kingdom is cost-effective and possibly cost-saving in the long term," the authors write. "A reduction in the cost of antiretroviral drugs (including the drugs used for PrEP) would substantially shorten the time for cost savings to be realized."
Several authors disclosed ties to the pharmaceutical industry.
Cambiano V, Miners A, Dunn D, et al. Cost-effectiveness of pre-exposure prophylaxis for HIV prevention in men who have sex with men in the UK: a modelling study and health economic evaluation [published online October 17, 2017]. Lancet Infect Dis. doi:10.1016/S1473-3099(17)30540-6