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Cost-effectiveness analysis of pre-exposure prophylaxis for the prevention of HIV in men who have sex with men in South Korea: a mathematical modelling study

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저자
Heun Choi ; Jiyeon Suh ; Woonji Lee ; Jun Hyoung Kim ; Jung Ho Kim ; Hye Seong ; Jin Young Ahn ; Su Jin Jeong ; Nam Su Ku ; Yoon Soo Park ; Joon Sup Yeom ; Changsoo Kim ; Hee Dae Kwon ; Davey M. Smith ; Jeehyun Lee ; Jun Yong Choi
키워드 (영문)
risk groupspre-exposure prophylaxismen who have sex with menmedicinehuman immunodeficiency virus (hiv)hiv transmissionenvironmental healthemtricitabinecost-effectiveness analysischristian ministryhiv infectionsmodelstheoreticalhumansmaleanti-hiv agentsprevention & controleconomicshomosexualitycost-benefit analysisquality of lifetherapeutic userepublic of korea
발행연도
2020-09
발행기관
medline
유형
Article
초록
In February 2018, the Ministry of Food and Drug Safety in Korea approved tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) co-formulate for use in pre-exposure prophylaxis (PrEP) for the prevention of human immunodeficiency virus (HIV) infection. This study aimed to estimate the cost-effectiveness of PrEP in men who have sex with men (MSM), a major risk group emerging in Korea. A dynamic compartmental model was developed for HIV transmission and progression in MSM aged 15-64 years. With a combined model including economic analysis, we estimated averted HIV infections, changes in HIV prevalence, discounted costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). PrEP was evaluated in both the general MSM and high-risk MSM populations and was assumed to reduce infection risk by 80%. Implementing PrEP in all MSM would avert 75.2% HIV infections and facilitate a gain of 37,372 QALYs at a cost of $274,822 per QALY gained over 20 years relative to the status quo. Initiating PrEP in high-risk MSM with an average of eight partners per year (around 20% of MSM) would improve the cost-effectiveness, averting 78.0% HIV infections and add 29,242 QALYs at a cost of $51,597 per QALY gained, which is within the willingness-to-pay threshold for Korea of $56,000/QALY gained. This result was highly sensitive to annual PrEP costs, quality-of-life for people who are on PrEP, and initial HIV prevalence. Initiating PrEP in a larger proportion of MSM in Korea would prevent more HIV infections, but at an increasing cost per QALY gained. Focusing PrEP on higher risk MSM and any reduction in PrEP cost would improve cost-effectiveness.
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
저널명
scientific reports
저널정보
(2020-09). scientific reports, Vol.10(1), 14609–14609
ISSN
0068-1261
EISSN
2045-2322
DOI
10.1038/s41598-020-71565-y
연구주제분류:
NHIMC 학술성과 > 1. 학술논문
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