Table 3.

Benefits and Costs of PrEP Strategies Over 20 Years – High-Risk MSM

									ICER Relative to§
Strategy*	New HIV Infections¶	HIV Infections Prevented†	HIV Prevalence at 20 Years	Total Costs of PrEP (billions) ¥#	Total Costs (billions)¥	Total QALYs¥	Incremental Costs¥‡ (billions)	Incremental QALYs¥‡	No PrEP	Next Lower Level of PrEP
100% of High-Risk Start PrEP	155,728	167,143 (52%)	17%	$85	$272	21,628,307	$75	1,439,261	$52,443	$62,818
50% of High-Risk Start PrEP	227,686	95,185 (29%)	23%	$42	$233	21,006,700	$36	817,655	$44,556	$47,803
20% of High-Risk Start PrEP	281,809	41,061 (13%)	28%	$17	$210	20,541,886	$14	352,840	$40,279	$40,279
Status Quo (No PrEP)	322,871		31%		$196	20,189,046

^*PrEP = preexposure prophylaxis. These strategies do not include any benefits to low-risk MSM, since we did not model mixing between high- and low-risk MSM in the high-risk analysis.

^¶New HIV infections and HIV infections prevented are undiscounted totals. Discounting infections at 3% annually reduces the number of infections averted for each strategy by approximately 24%.

^†The values in parentheses are the fraction of total HIV infections prevented.

^¥Costs and quality-adjusted life years (QALYs) are net present values (3% annual discount rate) over 20 years.

^#Total costs of PrEP include the cost of antiretroviral drugs for PrEP, costs of monitoring tests and physician visits, and initiation and discontinuation costs.

^‡Incremental costs and QALYs are relative to the status quo.

^§ICER = Incremental cost-effectiveness ratio, relative to the status quo of no PrEP use or the next lower level of PrEP use (i.e., the PrEP use scenario in the row below, with a lower percentage of MSM starting PrEP).