Truvada emtricitabine/tenofovir infectious data

Researchers at Stanford University reported data from a cost-effectiveness analysis showing that pre-exposure prophylaxis (PrEP) with Truvada could prevent a substantial number of new HIV infections among the general population of men who have sex with men, but that its use would be expensive. Specifically, the researchers said initiating PrEP in all U.S. men ages 13-64 who have sex with men would reduce the incidence of new HIV infections by 51% over 20 years vs. no PrEP, but at an ICER of $216,480 per QALY gained. Additionally, initiating PrEP in 20% of the population of U.S. men who have sex with men would reduce the incidence of new HIV infections by 13% over 20 years vs. no PrEP at an ICER of $172,091 per QALY gained. However, use of PrEP in a high-risk population of men who have sex with men, defined as having an average of 5 partners per year and estimated to about 20% of the population of men who have sex with men, would reduce the incidence of new HIV infections by 52% over 20 years vs. no PrEP at an ICER of $52,443 per QALY.

The researchers estimated that providing PrEP to all high-risk men who have sex with men for 20 years would cost $75.5 billion more in total healthcare-related costs compared to no PrEP, or about $600,000 per HIV infection prevented, whereas use of PrEP in 20% of the overall population of men who have sex with men was associated with incremental healthcare-related costs of $95 billion and $2 million per HIV infection prevented. The study used a dynamic model of HIV transmission and progression and assumed that the use of PrEP reduced the risk of HIV infection by 44% based on the results of the Phase III iPrEx trial (see BioCentury, Dec. 6, 2010). The cost-effectiveness analysis was funded by NIH's National Institute on Drug Abuse (NIDA), the U.S. Department of Veterans Affairs, NIH's National Institute of Allergy and Infectious Diseases (NIAID) and Stanford. Data were published in the Annals of Internal Medicine. ...