Determining the Most Appropriate Use of Available Regimens for HIV Preexposure Prophylaxis
Authors: David R. Holtgrave, Ronald O. Valdiserri
Journal: Annals of Internal Medicine (2022)

EditorialsApril 2022Determining the Most Appropriate Use of Available Regimens for HIV Preexposure ProphylaxisDavid R. Holtgrave, PhD and Ronald O. Valdiserri, MD, MPHDavid R. Holtgrave, PhDSchool of Public Health, University at Albany, State University of New York, Albany, New YorkSearch for more papers by this author and Ronald O. Valdiserri, MD, MPHRollins School of Public Health, Emory University, Atlanta, GeorgiaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-0057 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In their article, Neilan and colleagues describe the results of their economic analysis of the cost-effectiveness of long-acting injectable HIV preexposure prophylaxis (PrEP) (1). They used the widely published and well-reviewed Cost-Effectiveness of Preventing AIDS Complications (CEPAC) model to study 4 interventions: no PrEP, long-acting injectable cabotegravir (CAB-LA), and both branded and generic daily oral emtricitabine–tenofovir alafenamide. The model compared the cost and effectiveness of these interventions over a 10-year time horizon in a population consisting of men who have sex with men and transgender women at various levels of risk for HIV acquisition.To briefly summarize the researchers' complex ...References1. Neilan AM, Landovitz RJ, Le MH, et al. Cost-effectiveness of long-acting injectable HIV preexposure prophylaxis in the United States. A cost-effectiveness analysis. Ann Intern Med. 2022;175:479-89. doi:10.7326/M21-1548 LinkGoogle Scholar2. Neumann PJ, Cohen JT, Weinstein MC. Updating cost-effectiveness---the curious resilience of the $50,000-per-QALY threshold. N Engl J Med. 2014;371:796-7. [PMID: 25162885] doi:10.1056/NEJMp1405158 CrossrefMedlineGoogle Scholar3. The World Bank. GDP per capita (current US$). Accessed at https://data.worldbank.org/indicator/NY.GDP.PCAP.CD on 3 January 2022. Google Scholar4. Robinson LA, Hammitt JK, Chang AY, et al. Understanding and improving the one and three times GDP per capita cost-effectiveness thresholds. Health Policy Plan. 2017;32:141-145. [PMID: 27452949] doi:10.1093/heapol/czw096 CrossrefMedlineGoogle Scholar5. Harris NS, Johnson AS, Huang YA, et al. Vital signs: status of human immunodeficiency virus testing, viral suppression, and HIV preexposure prophylaxis - United States, 2013-2018. MMWR Morb Mortal Wkly Rep. 2019;68:1117-1123. [PMID: 31805031] doi:10.15585/mmwr.mm6848e1 CrossrefMedlineGoogle Scholar6. Hillis A, Germain J, Hope V, et al. Pre-exposure prophylaxis (PrEP) for HIV prevention among men who have sex with men (MSM): A scoping review on PrEP service delivery and programming. AIDS Behav. 2020;24:3056-3070. [PMID: 32274670] doi:10.1007/s10461-020-02855-9 CrossrefMedlineGoogle Scholar7. Sullivan PS, Mena L, Elopre L, et al. Implementation strategies to increase PrEP uptake in the south. Curr HIV/. AIDS Rep. 2019;16:259-269. [PMID: 31177363] doi:10.1007/s11904-019-00447-4 CrossrefMedlineGoogle Scholar8. Nydegger LA, Dickson-Gomez J, Ko TK. Structural and syndemic barriers to PrEP adoption among Black women at high risk for HIV: a qualitative exploration. Cult Health Sex. 2021;23:659-673. [PMID: 32212993] doi:10.1080/13691058.2020.1720297 CrossrefMedlineGoogle Scholar9. Furukawa NW, Zhu W, Huang YA, et al. National trends in drug payments for HIV preexposure prophylaxis in the United States, 2014 to 2018: a retrospective cohort study. Ann Intern Med. 2020;173:799-805. [PMID: 32894696] doi:10.7326/M20-0786 LinkGoogle Scholar10. White House Office of National AIDS Policy. National HIV/AIDS Strategy (2022-2025). Accessed at www.hiv.gov/federal-response/national-hiv-aids-strategy/national-hiv-aids-strategy-2022-2025 on 4 January 2022. Google Scholar Author, Article, and Disclosure InformationAffiliations: School of Public Health, University at Albany, State University of New York, Albany, New YorkRollins School of Public Health, Emory University, Atlanta, GeorgiaDisclosures: Authors have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-0057.Corresponding Author: David R. Holtgrave, PhD, School of Public Health, University at Albany, State University of New York, 1 University Place, Suite 100, Rensselaer, NY 12144.This article was published at Annals.org on 1 February 2022. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Long-Acting Injectable HIV Preexposure Prophylaxis in the United States Anne M. Neilan , Raphael J. Landovitz , Mylinh H. Le , Beatriz Grinsztejn , Kenneth A. Freedberg , Marybeth McCauley , Nattanicha Wattananimitgul , Myron S. Cohen , Andrea L. Ciaranello , Meredith E. Clement , Krishna P. Reddy , Emily P. Hyle , A. David Paltiel , and Rochelle P. Walensky Metrics April 2022Volume 175, Issue 4Page: 600-601KeywordsHIVHIV preventionHealth economicsPre-exposure prophylaxisPreexposure prophylaxisPrevention, policy, and public health ePublished: 1 February 2022 Issue Published: April 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...