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2019-02-14Zeitschriftenartikel DOI: 10.25646/5953
Cost-effectiveness and budget effect of pre-exposure prophylaxis for HIV-1 prevention in Germany from 2018 to 2058
dc.contributor.authorvan de Vijver, David A M C
dc.contributor.authorRichter, Ann-Kathrin
dc.contributor.authorBoucher, Charles A B
dc.contributor.authorGunsenheimer-Bartmeyer, Barbara
dc.contributor.authorKollan, Christian
dc.contributor.authorNichols, Brooke E
dc.contributor.authorSpinner, Christoph D
dc.contributor.authorWasem, Jürgen
dc.contributor.authorSchewe, Knud
dc.contributor.authorNeumann, Anja
dc.date.accessioned2019-03-14T12:31:12Z
dc.date.available2019-03-14T12:31:12Z
dc.date.issued2019-02-14none
dc.identifier.other10.2807/1560-7917.ES.2019.24.7.1800398
dc.identifier.urihttp://edoc.rki.de/176904/5988
dc.description.abstractBackground Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention strategy for men-who-have-sex-with-men (MSM). The high cost of PrEP has until recently been a primary barrier to its use. In 2017, generic PrEP became available, reducing the costs by 90%. Aim Our objective was to assess cost-effectiveness and costs of introducing PrEP in Germany. Methods We calibrated a deterministic mathematical model to the human immunodeficiency virus (HIV) epidemic among MSM in Germany. PrEP was targeted to 30% of high-risk MSM. It was assumed that PrEP reduces the risk of HIV infection by 85%. Costs were calculated from a healthcare payer perspective using a 40-year time horizon starting in 2018. Results PrEP can avert 21,000 infections (interquartile range (IQR): 16,000–27,000) in the short run (after 2 years scale-up and 10 years full implementation). HIV care is predicted to cost EUR 36.2 billion (IQR: 32.4–40.4 billion) over the coming 40 years. PrEP can increase costs by at most EUR 150 million within the first decade after introduction. Ten years after introduction, PrEP can become cost-saving, accumulating to savings of HIV-related costs of EUR 5.1 billion (IQR: 3.5–6.9 billion) after 40 years. In a sensitivity analysis, PrEP remained cost-saving even at a 70% price reduction of antiretroviral drug treatment and a lower effectiveness of PrEP. Conclusion Introduction of PrEP in Germany is predicted to result in substantial health benefits because of reductions in HIV infections. Short-term financial investments in providing PrEP will result in substantial cost-savings in the long term.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.rights(CC BY 3.0 DE) Namensnennung 3.0 Deutschlandger
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/de/
dc.subjectAIDSeng
dc.subjectGermanyeng
dc.subjectHIVeng
dc.subjectHIV infectioneng
dc.subjectMSMeng
dc.subjectPrEPeng
dc.subjectacquired immonodeficiency syndromeeng
dc.subjectcost-effectivenesseng
dc.subjectinfection controleng
dc.subjectmen-who-have-sex-with-meneng
dc.subjectmodellingeng
dc.subjectpreexposure prophylaxiseng
dc.subjectpreventioneng
dc.subjectpublic health policyeng
dc.subjectsexually transmitted infectionseng
dc.subjectviral infectionseng
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleCost-effectiveness and budget effect of pre-exposure prophylaxis for HIV-1 prevention in Germany from 2018 to 2058none
dc.typearticle
dc.identifier.urnurn:nbn:de:kobv:0257-176904/5988-0
dc.identifier.doihttp://dx.doi.org/10.25646/5953
dc.type.versionpublishedVersionnone
local.edoc.container-titleEurosurveillancenone
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2019.24.7.1800398#html_fulltextnone
local.edoc.container-publisher-nameInstitut de Veille Sanitairenone
local.edoc.container-volume24none
local.edoc.container-issue7none
local.edoc.container-reportyear2019none
local.edoc.container-year2019none
local.edoc.container-firstpage1none
local.edoc.container-lastpage9none
local.edoc.rki-departmentInfektionsepidemiologienone
dc.description.versionPeer Reviewednone

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