The Economic Evaluation of PrEP Strategy among MSM

Objective: Pre-exposure prophylaxis (PrEP) for AIDS is a biomedical prevention strategy. This research aims to conduct an economic evaluation of PrEP strategy through an analysis of its cost-effectiveness and cost-utility. Methods: Based on findings of previous studies and data from literature retrieval, this research adopts Markov model to compute the quality-adjusted life years (QALY) gained by MSM (men who have sex with men) as well as the cost and economic burden of disease with or without PrEP, and further analyzes PrEP's cost-effectiveness and cost-utility. Results: (1) If promoting PrEP to 10 million MSM for one year, 340,000 new HIV infections (suboptimal medication adherence) or 507,000 new HIV infections (optimal medication adherence) can be prevented. (2) With suboptimal medication adherence, the total cost of PrEP for 340,000 people in 30 years is 52.74 billion RMB, while without PrEP, the economic burden of the disease reaches 95.49 billion RMB. The cost of using PrEP to prevent one HIV infection is 155,100 RMB, and it can save 15,700 RMB per QALY gained. (3) With optimal medication adherence, it costs 61.97 billion RMB to provide PrEP for 507,000 people in 30 years, while 142.39 billion RMB to bear the economic burden of disease without PrEP. The cost to prevent one infection is 122,200 RMB, and it saves 19,800 RMB per QALY gained. Conclusions: The analysis of PrEP's cost-effectiveness and cost-utility indicates that this strategy is highly cost-effective and can be promoted among MSM in China.