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Can we afford to offer pre-exposure prophylaxis to MSM in Catalonia? Cost-effectiveness analysis and budget impact assessment

机译:我们可以提供在加泰罗尼亚的MSM预防预防预防吗? 成本效益分析和预算影响评估

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Pre-exposure prophylaxis (PrEP) effectiveness has been well established. This study aims to assess the cost-effectiveness of providing PrEP, estimate the number of eligible MSM, and its budget impact in Catalonia. Cost-effectiveness analysis compared costs of on daily basis and on demand PrEP to prevent one infection with lifetime costs of one HIV infection. We estimated the total cost of providing PrEP by estimating number of eligible MSM, and included in the budget impact assessment antiretroviral and laboratory costs. Costs were lower for the on-demand PrEP group by Euro64015.1 and the incremental benefit was nearly 15 life-years and 17 quality-adjusted life-years gained. The incremental cost-effectiveness ratio (ICER) was cost-effective at Euro6281.62 when undiscounted PrEP was given daily. On-demand PrEP can be considered cost-saving in 20 years if the price is reduced by 90%. The number of eligible MSM in Catalonia ranges from 5,989 to 10,972. At current antiretroviral costs, the annual cost would range between Euro25.3-46.7 million/year (on demand PrEP), and Euro42.9-78.7 million/year (daily basis PrEP). PrEP is most cost-effective if targeted towards groups with high incidence rates of over 3%/year. Beneficial ICER depends on reducing the current price of Truvada (R) and ensuring that effectiveness is maintained at high levels.
机译:预先接受预防(Prep)有效性已得到很好的成熟。本研究旨在评估提供准备的成本效益,估计符合条件的MSM的数量及其在加泰罗尼亚的预算影响。成本效益分析每天的成本和需求准备,以防止一种感染于一个艾滋病毒感染的终身成本。我们估计通过估计符合条件的MSM数量提供准备的总成本,并包含在预算影响评估抗逆转录病毒和实验室成本中。按需准备组的成本较低,欧元64015.1美元,增量效益近15年生命年份,17个质量调整的生命年限。当未被折扣预备每天给予未招备的准备时,增量成本效益率(ICER)在EURO6281.62中成本效益。如果价格降低90%,则按需准备将被认为是20年的成本节省。加泰罗尼亚符合条件的MSM数量为5,989至10,972。以目前的抗逆转录病毒成本为准,年费高出25.3-46.7百万美元/年(按需准备)和42.9-78.7百万美元/年(每日基础准备)。如果针对高出3%/年的群体,准备将准备最具成本效益。有益的捷豹取决于降低特鲁瓦达(R)的当前价格,并确保在高水平保持有效性。

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