HIV PreExposure Prophylaxis -PrEP- For MSM Found To Be Effective and Cost Saving Interview with:

Dr Valentina Cambiano PhD Institute for Global Health University College London London UK

Dr. Cambiano

Dr Valentina Cambiano PhD
Institute for Global Health
University College London
London UK What is the background for this study?

Response: Pre-Exposure Prophylaxis (PrEP) which involves the use of drugs, which are used to treat HIV, in people without HIV to prevent them from getting is a critical new advance in HIV prevention. It has been shown to reduce the risk of HIV infection by 86% and the benefits heavily out-weigh any concerns. However, introducing this intervention has a cost.

When we started working on this study the National Health Services was discussing whether to introduce PrEP and if so for which populations. Unfortunately, at the moment NHS England is not providing Pre-exposure prophylaxis. However, a large study, the PrEP impact trial, funded by the NHS, has just started and this will provide PrEP to 10,000 people. What are the main findings?

Response: The main findings of our paper are that, from the NHS perspective, the provision of PrEP to men having sex with men who report recent sex without a condom and recent HIV test is likely to be not only cost-effective for the UK health system, but cost-saving. Our projections suggest that by offering PrEP we would expect health improvements in terms of reduced HIV-related morbidity and mortality through infections prevented. In the long term it saves the NHS money through avoiding the future costs of treating people who would have otherwise become HIV positive. What should readers take away from your report?

Response: Investing in a PrEP programme for MSM in the cost of the UK is a good investment, as it will allow avoiding HIV infections and all the consequences of it and in the long run save moneys for the NHS that could be spent on other diseases. What recommendations do you have for future research as a result of this study?

Response: We have very strong evidence that oral PrEP works. Whether the introduction of PrEP is cost-effective depends mainly on the HIV incidence of a certain population, the cost of PREP and the cost of HIV treatment. No further research is needed to evaluate efficacy. However, it will be important to continue surveillance for other sexually transmitted infections and to conduct research in non MSM populations in high income settings and further implementation research on PrEP in sub Saharan Africa (and elsewhere) to understand how to increase demand and support retention on PrEP during periods of risk.  

Disclosures: I received personal fees in 2015 to present at an event funded by Merck Sharp & Dohme in Germany. Thank you for your contribution to the community.

Citation: The Lancet Infectious Diseases

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

Dr Valentina Cambiano, PhDCorrespondence information about the author Dr Valentina Cambiano, Alec Miners, PhD, David Dunn, PhD, Sheena McCormack, FRCP, Koh Jun Ong, MSc, O Noel Gill, FFPH, Anthony Nardone, PhD, Monica Desai, MRCP,
Nigel Field, PhD, Graham Hart, PhD, Valerie Delpech, PhD, Gus Cairns, MA,
Alison Rodger, PhD, Andrew N Phillips, PhD
Published: 17 October 2017

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on November 15, 2017 by Marie Benz MD FAAD