ArticleAnnals of internal medicine2016
Cost-Effectiveness of HIV Preexposure Prophylaxis for People Who Inject Drugs in the United States.
Article in Annals of internal medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Infectious Disease Modelling of HIV Prevention Interventions: A Systematic Review and Narrative Synthesis of Compartmental Models.PharmacoEconomics · 2023Pooled it
- Costs and Cost-Effectiveness of Biomedical, Non-Surgical HIV Prevention Interventions: A Systematic Literature Review.PharmacoEconomics · 2023Pooled it
- A Systematic Review of Simulation Models to Track and Address the Opioid Crisis.Epidemiologic reviews · 2022Pooled it
- Trajectories and Predictors of Longitudinal Preexposure Prophylaxis Adherence Among Men Who Have Sex With Men.The Journal of infectious diseases · 2018Trial
- Blending De-implementation and Implementation to Promote Adoption of Universal PrEP Guidelines: Determinants, Strategies, and Outcomes.Critical public health · 2025Article
- A multimorbidity model for estimating health outcomes from the syndemic of injection drug use and associated infections in the United States.BMC health services research · 2023Article
- Study protocol for an efficacy trial of the "PrEP for Health" intervention to increase HIV PrEP use among people who inject drugs.BMC public health · 2023Article
- The Cost-Effectiveness of HIV/STI Prevention in High-Income Countries with Concentrated Epidemic Settings: A Scoping Review.AIDS and behavior · 2022Article
- Integrating Harm Reduction into Outpatient Opioid Use Disorder Treatment Settings : Harm Reduction in Outpatient Addiction Treatment.Journal of general internal medicine · 2021Review
- National Trends in Drug Payments for HIV Preexposure Prophylaxis in the United States, 2014 to 2018 : A Retrospective Cohort Study.Annals of internal medicine · 2020Article
- Health outcomes and cost-effectiveness of diversion programs for low-level drug offenders: A model-based analysis.PLoS medicine · 2020Article
- Ending the HIV Epidemic Among Persons Who Inject Drugs: A Cost-Effectiveness Analysis in Six US Cities.The Journal of infectious diseases · 2020Article
- Ending the HIV epidemic in the USA: an economic modelling study in six cities.The lancet. HIV · 2020Article
- Competing biomedical HIV prevention strategies: potential cost-effectiveness of HIV vaccines and PrEP in Seattle, WA.Journal of the International AIDS Society · 2019Article
- Elimination of HIV transmission through novel and established prevention strategies among people who inject drugs.The lancet. HIV · 2019Review
- PrEP awareness, eligibility, and interest among people who inject drugs in Baltimore, Maryland.Drug and alcohol dependence · 2019Article
- Developing a dynamic HIV transmission model for 6 U.S. cities: An evidence synthesis.PloS one · 2019Article
- Cost-effectiveness of preexposure prophylaxis for HIV prevention for conception in the United States.AIDS (London, England) · 2018Article
- Perspectives on HIV pre-exposure prophylaxis (PrEP) utilization and related intervention needs among people who inject drugs.Harm reduction journal · 2018Article
- Cost and cost-effectiveness analysis of pre-exposure prophylaxis among men who have sex with men in two hospitals in Thailand.Journal of the International AIDS Society · 2018Observational
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundThe total population health benefits and costs of HIV preexposure prophylaxis (PrEP) for people who inject drugs (PWID) in the United States are unclear.
objectiveTo evaluate the cost-effectiveness and optimal delivery conditions of PrEP for PWID.
designEmpirically calibrated dynamic compartmental model. DATA SOURCES: Published literature and expert opinion. TARGET POPULATION: Adult U.S. PWID. TIME HORIZON: 20 years and lifetime.
interventionPrEP alone, PrEP with frequent screening (PrEP+screen), and PrEP+screen with enhanced provision of antiretroviral therapy (ART) for individuals who become infected (PrEP+screen+ART). All scenarios are considered at 25% coverage. OUTCOME MEASURES: Infections averted, deaths averted, change in HIV prevalence, discounted costs (in 2015 U.S. dollars), discounted quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. RESULTS OF BASE-CASE ANALYSIS: PrEP+screen+ART dominates other strategies, averting 26 700 infections and reducing HIV prevalence among PWID by 14% compared with the status quo. Achieving these benefits costs $253 000 per QALY gained. At current drug prices, total expenditures for PrEP+screen+ART could be as high as $44 billion over 20 years. RESULTS OF SENSITIVITY ANALYSIS: Cost-effectiveness of the intervention is linear in the annual cost of PrEP and is dependent on PrEP drug adherence, individual transmission risks, and community HIV prevalence. LIMITATION: Data on risk stratification and achievable PrEP efficacy levels for U.S. PWID are limited.
conclusionPrEP with frequent screening and prompt treatment for those who become infected can reduce HIV burden among PWID and provide health benefits for the entire U.S. population, but, at current drug prices, it remains an expensive intervention both in absolute terms and in cost per QALY gained. PRIMARY FUNDING SOURCE: National Institute on Drug Abuse.
Identifiers
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Registered trials
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