Truvada (Gilead Sciences) given to men at high risk for HIV would be cost-effective prophylaxis

Giving a daily Truvada (emtricitabine/tenofovir disoproxil fumarate) pill to help prevent HIV infection could significantly reduce the spread of AIDS, but only makes economic sense if used in select, high-risk groups, Stanford University researchers conclude. The researchers investigated whether it would be cost-effective to prescribe the pill daily in large populations, a prevention technique known as pre-exposure prophylaxis, or PrEP. Their economic model found this to be prohibitively expensive, however it showed that giving the pill to men who have sex with men (MSM) at high risk of acquiring HIV is an investment with good value. Without PrEP, the researchers calculated there would be more than 490,000 new infections among the MSM population in the US in the next 20 years. If just 20 percent of these men took the pill daily, there would be nearly 63,000 fewer infections. However, use of the drug by 20 percent of the MSM population would cost $98 billion over 20 years; if every man in this group took PrEP for 20 years, the costs would be a staggering $495 billion. the researchers looked at the option of giving PrEP only to men who are at high risk � those who have five or more sexual partners in a year. If just 20 percent of these high-risk individuals took the drug, 41,000 new infections would be prevented over 20 years at a cost of about $16.6 billion. At less than $50,000 per quality-adjusted life year gained, that strategy represents relatively good value. See: "The Cost-Effectiveness of Preexposure Prophylaxis for HIV Prevention in the United States in Men Who Have Sex With Men." Jessie L. Juusola et al Annals of Internal Medicine, April 17, 2012 vol. 156 no. 8 541-550.