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Canada: PrEP use now could save considerable sums in the future
Gus Cairns, 2015-03-20 10:20:00

A Canadian paper that weighs the cost of using pre-exposure prophylaxis (PrEP) to prevent HIV infections against the lifetime total cost of one HIV infection finds that, using figures available for Quebec and Ontario provinces, PrEP would be cost-saving under most scenarios, even if the overall lifetime cost of HIV care falls in the future.

The paper, published in January before the Conference on Retroviruses and Opportunistic Infections (CROI 2015), in fact almost certainly underestimates the potential cost benefits of PrEP. The researchers at the time of writing had access to estimates of the cost of PrEP and of HIV care but did not have access to the actual effectiveness of PrEP as seen in Ipergay, the study they use for their modelling. They therefore base their estimation of the cost of one HIV infection averted on the efficacy seen in the previous iPrEx study – 44%. In fact the effectiveness seen in Ipergay was 86% – meaning that the cost per infection averted would be considerably less.

In addition, the researchers use a high estimate of the overall cost of the drugs used in taking an Ipergay-style regimen. In the event, the average cost per person was about half of this.