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What do we know about the cost- effectiveness of HIV preexposure prophylaxis, and is it affordable?

Cambiano, V; Miners, A; Phillips, A; (2016) What do we know about the cost- effectiveness of HIV preexposure prophylaxis, and is it affordable? Current Opinion in HIV and AIDS , 11 (1) pp. 56-66. 10.1097/COH.0000000000000217. Green open access

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Abstract

PURPOSE OF REVIEW: The WHO recommends preexposure prophylaxis (PrEP) in populations at substantial risk of HIV. Despite a number of randomized controlled trials demonstrating its efficacy, and several ongoing implementation projects, PrEP is currently only available in a few countries. Modelling studies can provide useful insights into the long-term impact of introducing PrEP in different subgroups of the population. The review summarizes studies that either evaluated the cost–effectiveness or the cost of introducing PrEP, focusing on seven published in the last year. RECENT FINDINGS: These studies used a number of different types of models and investigated the introduction of PrEP in different settings. Among men having sex with men (MSM) in North America, PrEP ranged from being cost-saving (while benefiting population health) to costing US $160 000/quality-adjusted life-year gained. Among heterosexual sero-different couples, it varied from around US $5000 to US $10 000/disability-adjusted life-year averted, when PrEP was used until 6 or 12 months after the HIV-positive partner had initiated antiretroviral therapy (ART) in, respectively, Uganda and South Africa. SUMMARY: Future cost–effectiveness studies of PrEP should consider the HIV incidence, the level of uptake, the effect of its introduction on alternative prevention approaches, and the budget impact of rolling it out.

Type: Article
Title: What do we know about the cost- effectiveness of HIV preexposure prophylaxis, and is it affordable?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/COH.0000000000000217
Publisher version: http://dx.doi.org/10.1097/COH.0000000000000217
Language: English
Additional information: This is a non-final version of an article published in final form in Cambiano, V; Miners, A; Phillips, A; (2016) What do we know about the cost- effectiveness of HIV preexposure prophylaxis, and is it affordable? Current Opinion in HIV and AIDS , 11 (1) pp. 56-66. 10.1097/COH.0000000000000217.
Keywords: Science & Technology, Life Sciences & Biomedicine, Immunology, Infectious Diseases, affordability, cost-effectiveness, HIV prevention, modelling, preexposure prophylaxis, BUDGET IMPACT ANALYSIS, PREVENTION, MEN, SEX
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1482057
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