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New US PrEP cost-effectiveness model finds drug prices will need to drop substantially if HIV risk rises, or if adherence is only moderate
Gus Cairns, 2017-09-12 11:10:00
A new US model of the cost-effectiveness of pre-exposure prophylaxis (PrEP) for men who have sex with men (MSM), prepared by
researchers at Emory University in Atlanta, finds that taking even one year of PrEP
is more cost-effective than measures like kidney dialysis, if it is used by
people belonging to populations where HIV prevalence is at least 10%.
However, for PrEP to actually save money, relative to the
lifetime cost of treating the HIV infections that would otherwise happen, either
average adherence to PrEP needs to be high enough for it to be more than 92%
effective, or the population prevalence of HIV has to be over 20%, or there has to
be a reduction in the price of PrEP of at least 80%.
The model finds that the two most significant factors in
whether PrEP saves money or not are population HIV prevalence, and adherence. (PrEP
saves money when background HIV prevalence is high because it prevents more of
the infections that would otherwise have occurred.)
As a result, the authors say, PrEP could be cost-effective with
modest price reductions in states like Georgia but would need to be discounted
substantially, or only taken by a targeted few, to be cost-effective in
low-prevalence states like Montana.