Cost-effectiveness of HIV pre-exposure prophylaxis among people who inject drugs in Iran: an economic evaluation study

Résumé fourni par la source

The Iranian government does not fund HIV pre-exposure prophylaxis (PrEP), and PrEP is infrequently used in Iran, in part due to uncertainties about its cost-effectiveness, stigma, and lack of education. In this study, we assessed the cost-effectiveness of PrEP among Iranian people who inject drugs (PWID). The cost-effectiveness analysis compared PrEP-alone, a combination of PrEP with harm reduction (HR), and an HR-alone strategy among PWID over a 10-year time horizon. For the cost analysis, we considered the healthcare program development perspective. The primary outcome was disability-adjusted life years (DALYs) averted. Analyses included costs and health outcomes, as well as the incremental cost-effectiveness ratio (ICER), which was reported as the cost per DALYs averted. The PrEP-alone strategy, found to be dominated with an ICER of USD − 572.65 per DALY averted, was not cost-effective at a willingness-to-pay threshold of USD 4669.60 per DALY averted in Iran. In contrast, combining PrEP with HR was cost-effective at the same willingness-to-pay threshold. The ICER was USD 1,153.86 per DALYs averted for combining PrEP with HR compared to HR alone. The combination of PrEP with HR was a cost-effective strategy 76.3% of the time. Compared to HR, combining PrEP with HR is a cost-effective intervention among Iranian PWID for reducing the economic burden and improving health outcomes associated with HIV over a 10-year time horizon. Iran should add PrEP to its current HR programs for PWID.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.