Providing pre-exposure prophylaxis (PrEP) medication to men who have sex with men (MSM) who are at high risk of HIV infection could help to prevent up to one in four cases of HIV, a study has found
The study, published in the Lancet Infectious Diseases journal, estimates that providing PrEP could result in savings of up to £1bn over 80 years, because fewer men would require lifelong HIV treatment. This is the first study to assess the cost effectiveness of a national roll-out of PrEP.
The numbers of new HIV diagnoses in MSM in the UK have been at high levels for several years, with more than 3,000 new cases per year from 2012 to 2015, and there is a need for new prevention approaches.
PrEP, which is a combination of two anti-HIV drugs (emtricitabine and tenofovir) that are taken daily or around sexual activity to reduce a person’s risk of HIV infection, has been shown to be highly effective in preventing further infections, according to the study authors.
Researchers evaluated the cost effectiveness of PrEP when taken around sexual activity — for example, taking two pills before a sexual act, then one pill a day for every day having sex without a condom, and one pill a day for two days after sex.
They estimated costs, the number of HIV infections, and associated quality of life for MSM if PrEP was introduced in April–June 2016. They compared results against projections for a scenario where PrEP would not be introduced.
Study author Valentina Cambiano, University College London (UCL), said there was “no doubt about the effectiveness of PrEP”.
“In addition to delivering a substantial health benefit, our work suggests that introduction of PrEP will ultimately lead to a saving in costs, as a result of decreased numbers of men in need of lifelong HIV treatment,” she said.
 Cambiano V, Miners A, Dunn D et al. Cost-effectiveness of pre-exposure prophylaxis for HIV prevention in men who have sex with men in the UK: a modelling study and health economic evaluation. Lancet Infect Dis 2017. doi: 10.1016/S1473-3099(17)30540-6