Cost-Effectiveness of Pre-Exposure Prophylaxis Among Adolescent Sexual Minority Males

Details

• Alternative Title:
  J Adolesc Health
• Personal Author:
  Wang, Li Yan ; Hamilton, Deven T. ; Rosenberg, Eli S. ; Aslam, Maria V. ; Sullivan, Patrick S. ; Katz, David A. ; Dunville, Richard L. ; Barrios, Lisa C. ; Goodreau, Steven M.
• Description:
  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.
  
  
• Subjects:
  Adolescent Cost-Benefit Analysis HIV Infections Homosexuality, Male Humans Male Pre-Exposure Prophylaxis Quality-Adjusted Life Years Sexual And Gender Minorities
• Source:
  J Adolesc Health. 66(1):100-106
• Pubmed ID:
  31757626
• Pubmed Central ID:
  PMC9258617
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; P30 AI027757/AI/NIAID NIH HHSUnited States/
• Volume:
  66
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:7f55263528cfce7fdb508af63a479725e9f98c4673efb8852fc14a25642777cf
• Download URL:
  https://stacks.cdc.gov/view/cdc/119355/cdc_119355_DS1.pdf
• File Type:
  [PDF - 344.47 KB ]