Cost-Effectiveness of Pre-Exposure Prophylaxis Among Adolescent Sexual Minority Males.
J Adolesc Health
; 66(1): 100-106, 2020 01.
Article
em En
| MEDLINE
| ID: mdl-31757626
ABSTRACT
PURPOSE:
Pre-exposure prophylaxis (PrEP) has been proven safe and effective in preventing HIV among adolescent sexual minority males (ASMM), but the cost-effectiveness of PrEP in ASMM remains unknown. Building on a recent epidemiological network modeling study of PrEP among ASMM, we estimated the cost-effectiveness of PrEP use in a high prevalence U.S. setting with significant disparities in HIV between black and white ASMM.METHODS:
Based on the estimated number of infections averted and the number of ASMM on PrEP from the previous model and published estimates of PrEP costs, HIV treatment costs, and quality-adjusted life years (QALYs) gained per infection prevented, we estimated the cost-effectiveness of PrEP use in black and white ASMM over 10 years using a societal perspective and lifetime horizon. Effectiveness was measured as lifetime QALYs gained. Cost estimates included 10-year PrEP costs and lifetime HIV treatment costs saved. Cost-effectiveness was measured as cost/QALY gained. Multiple sensitivity analyses were performed on key model input parameters and assumptions used.RESULTS:
Under base-case assumptions, PrEP use yielded an incremental cost-effectiveness ratio of $33,064 per QALY in black ASMM and $427,788 per QALY in white ASMM. In all sensitivity analyses, the cost-effectiveness ratio of PrEP use remained <$100,000 per QALY in black ASMM and >$100,000 per QALY in white ASMM.CONCLUSIONS:
We found favorable cost-effectiveness ratios for PrEP use among black ASMM or other ASMM in communities with high HIV burden at current PrEP costs. Clinicians providing services in high-prevalence communities, and particularly those serving high-prevalence communities of color, should consider including PrEP services.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Anos de Vida Ajustados por Qualidade de Vida
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Profilaxia Pré-Exposição
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Minorias Sexuais e de Gênero
Tipo de estudo:
Health_economic_evaluation
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Risk_factors_studies
Limite:
Adolescent
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Humans
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Male
Idioma:
En
Revista:
J Adolesc Health
Assunto da revista:
PEDIATRIA
Ano de publicação:
2020
Tipo de documento:
Article