Table 4. Cost: assumptions (US$ in publication).
Reference | Drug Costs | Service Costs | Costs above Service Level | ART Costs | Discount Rate |
Generalised epidemics in southern Africa | |||||
Abbas [25] | Drug costs (2007 US$, per person-y): high, US$700; moderate, US$318; low, US$208. | Not included | Not included | Excluded costs of provision of ART. | Undiscounted |
Pretorius [30] | Drugs (2010 US$): US$134 per person-y. | VCT, tests (serum creatinine, hepatitis B, pregnancy): US$16 per person-y. | Not included | Average cost of ART: US$600/person-y | Undiscounteda |
Hallett [28] | Drugs and monitoring costs (2011 US$): US$150–US$250 per person-y. Includes lab testing, personnel, and drug costs. | See drug costs for description | Not included | Average cost of ART: US$450–US$800/person-y | 3% annual discount rate |
Williams [32] | Microbicide only (2010 US$): US$0.60 for two applications including gel, wrapping, and applicator. | Not included | Not included | Lifetime cost of ART: US$8,396 (for 23 y, approx. US$365/person-y) | Undiscounteda |
Walensky [31] | Applicator and gel (2010 US$): US$0.32/dose, US$5/mo | HIV tests, chemistry panels (urea, creatinine, bilirubin, aspartate aminotransferase, alanine aminotransferase testing, and reagents, staff salary, equipment, overhead, and facilities): total US$188 per person-y. | See service costs for description | Average cost of ART: US$105–US$504/person-y | 3% annual discount rate |
Alistar [37] | Drugs (2012 US$): US$80 | All individuals in the population incur an annual US$200 cost of general medical care. | Not included. | Average cost of ART: US$150/person-y. An additional US$1,000 per person-y in medical costs for HIV-infected individuals. | 3% annual discount rate |
Cremin [36] | Drugs (2012 US$): US$118 per person-y. | Testing (US$20), human resources (US$91), facilities (US$23). | Not included. | Average cost of ART: US$600/person-y | 3% annual discount rate |
Concentrated epidemics among MSM in high-income countries | |||||
Desai [26] | Drugs (2007 US$): US$31/tablet; (US$11,315 per person-y) | Medical screening, ongoing medical monitoring and adherence promotion (1 mo after initiation and at 3-mo intervals): 1st year, US$1,300; each year after, US$1,020 per person/y. | Not included | Lifetime cost of ART: US$343,130 | 3% annual discount rate |
5-y combined cost for drug and support service: US$58,700 per person. | See drug costs for description | ||||
Paltiel [34] | Drugs (2006US$): US$72–US$725/person-month; (US$864–US$8,700 per person-y) | Quarterly laboratory monitoring, semi-annual physical examinations, and annual full lipid panels: US$28 per person-month. | Not included | Excluded costs of provision of ART. | 3% annual discount rate |
Approx. combined cost: US$1,200–US$9,036 per person-y. | |||||
Koppenhaver [29] | Drugs (2010 US$): US$22 per person-day; (US$8,030 per person-y) | Quarterly HIV testing and monitoring for adverse events as gathered in Desai et al. [26]. | Not included | Lifetime cost of ART: US$343,130 | 3% annual discount rate |
Juusola [35] | Drugs (2010 US$): US$776 per person-month (approx. US$9,312 per person-y) | Based on CDC interim PrEP guidelines [9]: clinical screening, physician visits 5/y (HIV testing, risk-reduction counseling, condoms), testing for STI biannually, and renal function yearly: US$10,083 per person-y. | Not included | Average cost of ART: 15,589/person-y (for 23 y, US$365,470) | 3% annual discount rate |
Concentrated epidemics among MSM in low- and middle-income countries | |||||
Gomez [27] | Drugs (2011 US$): US$420 and US$600 per person-y. | Based on CDC interim PrEP guidelines [9]. HIV screening, HIV testing every 3 mo during use, testing for renal function yearly, outreach and counselling services, condom and lubricant provision. US$525–US$830 per person-y. | Systemic costs at a 5% mark-up. Included in service costs. | Excluded costs of provision of ART. Cost of ART included in sensitivity analysis: US$1,000–US$3,000 per person-y. | 3% annual discount rate |
Concentrated epidemics among PWID in low- and middle-income countries | |||||
Alistar [33] | High PrEP annual cost (US$2011): US$6,000 | US$310 general medical costs, HIV medical costs are US$1,200. | Not included | ART costs US$450/y for general population, US$950 for PWID not in methadone, and US$750 for PWID in methadone, to account for counseling and additional efforts needed for IDUs | 3% annual discount rate |
approx, approximately; CDC, Centers for Disease Control and Prevention; n/a, not applicable/not available; person-y, person-year; VCT, voluntary counselling and testing.
Assumed.