ArticleThe Lancet. Global health2025
Cost-effective pricing of long-acting injectable HIV pre-exposure prophylaxis for adolescent girls and young women in South Africa: a model-based analysis.
Article in The Lancet. Global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled 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
- Defining HIV Pre-Exposure Prophylaxis (PrEP) Persistence: A Scoping Review.Journal of the International AIDS Society · 2026Article
- Long-Acting PrEP for People With High Vulnerability to HIV Acquisition in Brazil: A Cost-Effectiveness Analysis.Journal of the International AIDS Society · 2026Article
- Potential long-acting tuberculosis treatment for people with HIV: cost-effectiveness benchmarks.Annals of the American Thoracic Society · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
backgroundLong-acting, injectable cabotegravir (CAB-LA) is more effective than daily oral tenofovir disoproxil fumarate and emtricitabine (TDF-FTC) for HIV pre-exposure prophylaxis (PrEP). We aimed to estimate the maximum price premium: the greatest price markup that society should be willing to accept for CAB-LA compared with TDF-FTC among adolescent girls and young women aged 15-29 years in South Africa.
methodsUsing the Cost-effectiveness of Preventing AIDS Complications model, we simulated adolescent girls and young women (aged 15-29 years) with characteristics similar to the targeted enrolment population of the FastPrEP study in Cape Town, South Africa, to compare daily oral TDF-FTC with bimonthly CAB-LA. The simulation model captured individual and population-level effects from a health-care sector perspective. Model inputs included HIV incidence (off PrEP 3·2 per 100 person-years, TDF-FTC 1·9 per 100 person-years, and CAB-LA 0·2 per 100 person-years), 10-year cumulative HIV transmissions to partners, and PrEP persistence (TDF-FTC 88% and CAB-LA 85% at 2 years) from published data. Annual costs included PrEP programme (TDF-FTC US$28 and CAB-LA $45), PrEP drug (TDF-FTC $40), antiretroviral therapy ($50-890), and HIV-related care ($230-1800). Model-projected outcomes included incident infections among adolescent girls and young women, transmissions, life-years, costs, incremental cost-effectiveness ratios (ICERs), and the maximum price premium of CAB-LA drug at a willingness-to-pay threshold of 50% of the gross domestic product of South Africa per capita ($3500 per life-year). Key parameters were varied in sensitivity analyses.
findingsPer 10 000 adolescent girls and young women and their partners over 10 years, our model estimates that infections and transmissions would be higher, and life-years would be lower using a TDF-FTC strategy (1980 infections, 450 transmissions, and 88 400 life-years) compared with CAB-LA (1080 infections, 220 transmission, and 88 600 discounted life-years). At 10 years, CAB-LA would be cost-effective with a maximum price premium over TDF-FTC of $38 per year (maximum price of $78 per year) and cost-saving at a drug price of $65 per year. Considering a lifetime horizon, the maximum price premium over TDF-FTC could be seven times higher: $232 per year (maximum price $272 per year).
interpretationOur findings suggest that a CAB-LA strategy could reduce transmissions and increase life-years compared with TDF-FTC. The availability of an inexpensive and effective oral alternative medication for adolescent girls and young women in South Africa limits the price that payers should be willing to accept for CAB-LA with a modest markup over TDF-FTC.
fundingNational Institutes of Health and Massachusetts General Hospital Executive Committee on Research.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.