Preexposure Prophylaxis to Prevent HIV in Men Who Have Sex with Men: At What Cost?

Of the 50,000 new cases of HIV infection annually in the U.S., more than half occur in men who have sex with men (MSM). In a study among HIV-negative MSM, daily prophylaxis with antiretroviral therapy lowered the incidence of HIV infection by 50% to 70% (JW AIDS Clin Care Nov 23 2010). In new research, investigators used modeling to determine whether preexposure antiretroviral prophylaxis is cost-effective for preventing HIV infection among MSM.

Initiating preexposure prophylaxis in 20% of MSM for 20 years would cost US$98 billion in healthcare-related costs and would save $3 billion in prevented HIV care; the cost per quality-adjusted life-year (QALY) gained would be $172,000. The per-QALY cost for covering 50% of MSM would be $188,000. Tar…