ArticleThe Lancet. Infectious diseases2016
Cost-effectiveness analysis of pre-exposure prophylaxis for HIV-1 prevention in the Netherlands: a mathematical modelling study.
Article in The Lancet. Infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 3 of them syntheses that pooled it.
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Who cites it
57 citing papers in PubMed, 3 syntheses or guidelines pooled it, 109 citations in OpenAlex.
- Prospects of HIV elimination among men who have sex with men: A systematic review of modeling studies.PLoS computational biology · 2026Pooled it
- Evolving landscape of economic evaluations of HIV pre-exposure prophylaxis and pre-exposure prophylaxis implementation strategies: a systematic review.Journal of the International AIDS Society · 2025Pooled it
- Costs and Cost-Effectiveness of Biomedical, Non-Surgical HIV Prevention Interventions: A Systematic Literature Review.PharmacoEconomics · 2023Pooled it
- Epidemiologic Impact of Prioritizing Long-Acting Injectable Cabotegravir to Men Who Have Sex With Men With Low Pre-Exposure Prophylaxis Use Adherence in the Netherlands: A Mathematical Modeling Study.Journal of acquired immune deficiency syndromes (1999) · 2026Article
- Testing paradox may explain increased observed prevalence of bacterial STIs among MSM on HIV PrEP: A modeling study.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- Epidemiological impact and cost-effectiveness analysis of PrEP provision expansion among MSM in the Netherlands.Journal of the International AIDS Society · 2025Article
- Model-based evaluation of the impact of a potential HIV cure on HIV transmission dynamics.Nature communications · 2025Article
- A modeling study of pre-exposure prophylaxis to eliminate HIV in Taiwan by 2030.Communications medicine · 2025Article
- The HIV Epidemic in the United States - Epidemiological Projections and Public Economic Impact of Achieving Zero Transmission Goals.ClinicoEconomics and outcomes research : CEOR · 2025Article
- Interventions for stigma reduction in HIV treatment and prevention designed to enhance antiretroviral uptake and adherence: A systematic review.PLOS global public health · 2025Article
- Economic evaluation of short message service intervention for HIV prevention among men who have sex with men in China: a modelling study.BMC public health · 2024Article
- Health Economics Research on Non-surgical Biomedical HIV Prevention: Identifying Gaps and Proposing a Way Forward.PharmacoEconomics · 2023Article
- Population-level impact of expanding PrEP coverage by offering long-acting injectable PrEP to MSM in three high-resource settings: a model comparison analysis.Journal of the International AIDS Society · 2023Article
- Temporal trends in inequalities of the burden of HIV/AIDS across 186 countries and territories.BMC public health · 2023Article
- Multi-dimensional mismatch and barriers for promoting PrEP among men who have sex with men in China: a cross sectional survey from the Demand-side.AIDS research and therapy · 2023Article
- Awareness and use of HIV pre-exposure prophylaxis and factors associated with awareness among MSM in Beijing, China.Scientific reports · 2023Article
- Prevalence of HIV in Kazakhstan 2010-2020 and Its Forecasting for the Next 10 Years.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Cost-effectiveness analysis of the daily HIV pre-exposure prophylaxis in men who have sex with men in Barcelona.PloS one · 2023Article
- Eligibility criteriaEpidemiology and infection · 2022Article
- Moving towards zero new HIV infections: The importance of combination prevention.The Lancet regional health. Western Pacific · 2022Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPre-exposure prophylaxis (PrEP) with tenofovir and emtricitabine prevents HIV infections among men who have sex with men (MSM). PrEP can be given on a daily or intermittent basis. Unfortunately, PrEP is not reimbursed in most European countries. Cost-effectiveness analyses of PrEP among MSM in Europe are absent but are key for decision makers to decide upon PrEP implementation.
methodsWe developed a deterministic mathematical model, calibrated to the well defined Dutch HIV epidemic among MSM, to predict the effect and cost-effectiveness of PrEP. PrEP was targeted to 10% of highly sexually active Dutch MSM over the coming 40 years. Cost-effectiveness ratios were calculated to predict the cost-effectiveness of daily and on-demand PrEP. Cost-effectiveness ratios below €20 000 were considered to be cost-effective in this analysis.
findingsWithin the context of a stable HIV epidemic, at 80% effectiveness and current PrEP pricing, PrEP can cost as much as €11 000 (IQR 9400-14 100) per quality-adjusted life-year (QALY) gained when used daily, or as little as €2000 (IQR 1300-3000) per QALY gained when used on demand. At 80% effectiveness, daily PrEP can be considered cost-saving if the price of PrEP is reduced by 70%, and on-demand PrEP can be considered cost-saving if the price is reduced by 30-40%.
interpretationPrEP for HIV prevention among MSM in the Netherlands is cost-effective. The use of PrEP is most cost-effective when the price of PrEP is reduced through on-demand use or through availability of generic PrEP, and can quickly be considered cost-saving.
fundingNone.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.