Table 3.
Lifetime 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) | 1 715 802 | 163 595 | 54 759 | |||||
| Optimistic scenario | ||||||||
| Unprioritized PrEP, 2.5% | 1 702 971 | 0.7 | 163 686 | 91 480 | 54 893 | 134 | 12 982 | 1470 |
| Unprioritized PrEP, 5% | 1 690 331 | 1.5 | 163 776 | 181 562 | 55 029 | 270 | 13 153 | 1489 |
| Unprioritized PrEP, 10% | 1 665 622 | 2.9 | 163 952 | 357 560 | 55 305 | 546 | 13 502 | 1528 |
| Unprioritized PrEP, 15% | 1 641 672 | 4.3 | 164 123 | 528 065 | 55 587 | 828 | 13 857 | 1568 |
| Age-prioritized PrEP, 2.5% | 1 693 442 | 1.3 | 163 767 | 171 926 | 54 839 | 81 | 4420 | 470 |
| Age-prioritized PrEP, 5% | 1 671 067 | 2.6 | 163 938 | 343 418 | 54 921 | 163 | 4451 | 474 |
| Age-prioritized PrEP, 10% | 1 626 063 | 5.2 | 164 281 | 686 382 | 55 087 | 328 | 4485 | 479 |
| Age-prioritized PrEP, 15% | 1 580 162 | 7.9 | 164 627 | 1 032 275 | 55 251 | 493 | 4459 | 477 |
| Risk-prioritized PrEP | 1 647 881 | 4.0 | 164 062 | 467 454 | 54 443 | –315 | CS | CS |
| Conservative scenario | ||||||||
| Unprioritized PrEP, 2.5% | 1 709 004 | 0.4 | 163 639 | 44 543 | 54 918 | 159 | 27 866 | 3578 |
| Unprioritized PrEP, 5% | 1 702 352 | 0.8 | 163 683 | 88 151 | 55 078 | 320 | 28 261 | 3628 |
| Unprioritized PrEP, 10% | 1 689 476 | 1.5 | 163 767 | 172 637 | 55 403 | 644 | 29 061 | 3731 |
| Unprioritized PrEP, 15% | 1 677 151 | 2.3 | 163 848 | 253 610 | 55 731 | 973 | 29 873 | 3836 |
| Age-prioritized PrEP, 2.5% | 1 703 761 | 0.7 | 163 680 | 84 941 | 54 881 | 123 | 11 941 | 1444 |
| Age-prioritized PrEP, 5% | 1 691 899 | 1.4 | 163 763 | 168 507 | 55 005 | 247 | 12 106 | 1465 |
| Age-prioritized PrEP, 10% | 1 668 632 | 2.7 | 163 927 | 331 820 | 55 258 | 500 | 12 401 | 1506 |
| Age-prioritized PrEP, 15% | 1 646 111 | 4.1 | 164 084 | 489 307 | 55 517 | 758 | 12 721 | 1549 |
| Risk-prioritized PrEP | 1 690 608 | 1.5 | 163 742 | 147 148 | 54 610 | –149 | CS | CS |
Abbreviations: CS, cost-saving; 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 shown are calculated relative to the reference scenario.