Cost and cost‐effectiveness analysis of pre‐exposure prophylaxis among men who have sex with men in two hospitals in Thailand

作者：Chutima Suraratdecha, Robyn M. Stuart, Chomnad Manopaiboon, Dylan Green, Cheewanan Lertpiriyasuwat, David P. Wilson, Patcharaporn Pavaputanon, Prin Visavakum, Patama Monkongdee, Thana Khawcharoenporn, Phiphatthananon Tharee, Chonticha Kittinunvorakoon, Michael Martin · 发表于：Journal of the International AIDS Society · 年份：2018 · DOI：10.1002/jia2.25129 · 被引用次数：36 · 研究领域：HIV/AIDS Research and Interventions、HIV, Drug Use, Sexual Risk、Sex work and related issues

INTRODUCTION: In 2014, the Government of Thailand recommended pre-exposure prophylaxis (PrEP) as an additional HIV prevention programme within Thailand's National Guidelines on HIV/AIDS Treatment Prevention. However, to date implementation and uptake of PrEP programmes have been limited, and evidence on the costs and the epidemiological and economic impact is not available. METHODS: We estimated the costs associated with PrEP provision among men having sex with men (MSM) participating in a facility-based, prospective observational cohort study: the Test, Treat and Prevent HIV Programme in Thailand. We created a suite of scenarios to estimate the cost-effectiveness of PrEP and sensitivity of the results to the model input parameters, including PrEP programme effectiveness, PrEP uptake among high-risk and low-risk MSM, baseline and future antiretroviral therapy (ART) coverage, condom use, unit cost of delivering PrEP, and the discount rate. RESULTS: Drug costs accounted for 82.5% of the total cost of providing PrEP, followed by lab testing (8.2%) and personnel costs (7.8%). The estimated costs of providing the PrEP package in accordance with the national recommendation ranges from US$223 to US$311 per person per year. Based on our modelling results, we estimate that PrEP would be cost-effective when provided to either high-risk or all MSM. However, we found that the programme would be approximately 32% more cost-effective if offered to high-risk MSM than it would be if offered ...