aidsmap | In Asia, on-demand PrEP could be an “economically efficient” way to prevent HIV

aidsmap news story

A model of the likely efficacy and cost-effectiveness of PrEP in 15 Asian countries plus Australia finds that long-acting injectable PrEP using the drug cabotegravir, if based on patterns of preference and usage established in a previous study, would reduce the number of HIV infections in gay and bisexual men by at least 50% more than oral PrEP.

Crucially though, it also finds that cabotegravir injections would be unaffordable in terms of the cost per HIV infection averted if they are only discounted, compared to the US price, by the same amount as oral PrEP currently is.

Oral PrEP, in contrast, would likely be cost-saving or nearly so, in terms of the cost per disability-adjusted-life-year (DALY), in all five higher income countries studied except for Japan. In middle-income countries the cost even of daily oral PrEP per DALY would tend to exceed cost-effectiveness thresholds at current, commercially available, prices.

However, on-demand PrEP is expected to be as effective as daily oral PrEP, while being considerably more affordable. This would bring the cost-effectiveness nearer to what most countries can afford, and the authors say that policy makers need to consider the “economic efficiency” of on-demand PrEP.

The study also modelled PrEP efficacy and cost in transgender women in the 11 countries defined as middle-income, with roughly similar results; data were not available for trans women in the five high-income countries.

Read the full news story here.