A national programme of pre-exposure prophylaxis for men who have sex with men is cost-effective, according to an analysis published today.
The study is the latest to support the introduction of PrEP, currently under way on a trial basis.
"Sex between men is the predominant mode of HIV transmission in Europe and other high-income settings," says researcher Dr Valentina Cambiano of University College London, UK. She believes that additional prevention approaches are needed, of which a promising option is pre-exposure prophylaxis based on emtricitabine and tenofovir.
"PrEP has been shown to be highly efficacious among men who have sex with men," write Dr Cambiano and colleagues in today’s (18 October) Lancet Infectious Diseases.
"However, when considering a PrEP programme in the UK for men who have sex with men, important questions are whether it is cost-effective and its budgetary impact."
They carried out a modelling study and economic evaluation using many sources of information in the UK. This indicated that a PrEP programme, with around 4,000 men initiated on PrEP by the end of the first year and almost 40,000 by the end of the 15th year, would lead to a total cost saving of one billion pounds. It would avoid 25% of HIV infections and lead to a gain of 40,000 quality adjusted life years, or an 80 year period.
"This analysis suggests that the introduction of a PrEP programme for men who have sex with men in the UK is cost-effective and possibly cost-saving in the long term," they 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 realised."
Co-author Dr Alison Rodger said: "As antiretroviral drug patents expire over the next few years, the emergence of generic drugs could result in large cost reductions for PrEP, and these reductions could help to limit the impact of PrEP on NHS budgets."
Cambiano, V. 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. The Lancet Infectious Diseases 18 October 2017; doi: 10.1016/S1473-3099(17)30540-6 [abstract]
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