Is PrEP Cost-Effective for People Who Inject Drugs in the U.S.?

In the model, PrEP without provision of screening and treatment resources was an inefficient strategy. However, HIV screening and immediate ART identified to those who test positive and PrEP provided to 25% of PWID, would avert 26,700 new infections and reduce HIV prevalence among PWID by 14% over a 20-year period. The incremental cost-effectiveness of this intervention was estimated at $253,000 per quality-adjusted life year (QALY), far higher than the frequently cited threshold of <$100,000/QALY for good value in the U.S., and the implementation cost was estimated at $2.2 billion per year — about 9% of the 2015 federal budget for domestic HIV. Drug cost drives most of the required budget; when tenofovir /FTC costs were decreased by 65% in…