Table 2.
Ten-Year Costs and Outcomes of Base-Case Preexposure Prophylaxis Strategies
| Scenario | HIV Infectionsa |
Life-yearsb |
Cost, Million $b |
ICERb |
||||
|---|---|---|---|---|---|---|---|---|
| New Cases, No. | IP, % | Lived, Thousands | LYG, No. | Total Cost | Cost Increase | $/IP | $/LYG | |
| Reference (no PrEP) | 682 875 | 55 480 | 20 004 | |||||
| Optimistic scenario | ||||||||
| Unprioritized PrEP, 2.5% | 672 053 | 1.6 | 55 481 | 1065 | 20 193 | 188 | 20 905 | 176 755 |
| Unprioritized PrEP, 5% | 661 434 | 3.1 | 55 482 | 2121 | 20 382 | 377 | 21 124 | 177 749 |
| Unprioritized PrEP, 10% | 640 791 | 6.2 | 55 484 | 4207 | 20 761 | 756 | 21 569 | 179 739 |
| Unprioritized PrEP, 15% | 620 926 | 9.1 | 55 486 | 6257 | 21 142 | 1137 | 22 022 | 181 734 |
| Age-prioritized PrEP, 2.5% | 663 108 | 2.9 | 55 482 | 2130 | 20 184 | 180 | 10 880 | 84 418 |
| Age-prioritized PrEP, 5% | 643 476 | 5.8 | 55 484 | 4261 | 20 365 | 361 | 10 945 | 84 624 |
| Age-prioritized PrEP, 10% | 604 433 | 11.5 | 55 488 | 8547 | 20 729 | 725 | 11 046 | 84 820 |
| Age-prioritized PrEP, 15% | 565 261 | 17.2 | 55 493 | 12 832 | 21 097 | 1092 | 11 094 | 85 105 |
| Risk-prioritized PrEP | 627 257 | 8.1 | 55 484 | 4341 | 20 018 | 13.6 | 298 | 3144 |
| Conservative scenario | ||||||||
| Unprioritized PrEP, 2.5% | 676 308 | 1.0 | 55 480 | 695 | 20 197 | 192 | 35 090 | 276 605 |
| Unprioritized PrEP, 5% | 669 885 | 1.9 | 55 481 | 1384 | 20 389 | 385 | 35 494 | 278 240 |
| Unprioritized PrEP, 10% | 657 454 | 3.7 | 55 483 | 2739 | 20 776 | 771 | 36 310 | 281 510 |
| Unprioritized PrEP, 15% | 645 558 | 5.5 | 55 484 | 4069 | 21 163 | 1159 | 37 137 | 284 781 |
| Age-prioritized PrEP, 2.5% | 670 743 | 1.8 | 55 481 | 1405 | 20 192 | 187 | 18 429 | 133 428 |
| Age-prioritized PrEP, 5% | 658 795 | 3.5 | 55 483 | 2807 | 20 380 | 376 | 18 595 | 133 808 |
| Age-prioritized PrEP, 10% | 635 344 | 7.0 | 55 485 | 5604 | 20 758 | 754 | 18 893 | 134 532 |
| Age-prioritized PrEP, 15% | 612 623 | 10.3 | 55 488 | 8357 | 21 138 | 1134 | 19 213 | 135 695 |
| Risk-prioritized PrEP | 652 662 | 4.4 | 55 482 | 2690 | 20 036 | 31.1 | 1242 | 11 568 |
Abbreviations: HIV, human immunodeficiency virus; ICER, incremental cost-effectiveness ratio; IP, infections prevented; LYG, life-years gained; PrEP, preexposure prophylaxis.
a Undiscounted new infections and infections prevented are shown.
b Costs and life-years shown are discounted 3% annually. Cost and health outcomes are discounted 3% annually in ICER calculations. ICERs are calculated relative to the reference scenario.