WASHINGTON, April 16, 2012 (AFP) - Gay men who have five or more sex
partners per year are part of a high-risk group that could benefit from a
daily pill to ward off HIV, said a cost-benefit analysis by US researchers on
The study by experts at Stanford University, published in the Annals of
Internal Medicine, looked at the costs involved with prescribing a $26 a day
pill to men who have sex with men.
The pill, Truvada (tenofovir-emtricitabine), was shown in a landmark 2010
trial published in the New England Journal of Medicine to prevent HIV
infections in as many as 73 percent of gay men who took it regularly.
Gay men account for the more than half of the 56,000 new cases yearly of
human immunodeficiency virus in the United States, according to the Centers
for Disease Control and Prevention.
However, questions have been raised about whether it would make financial
sense to recommend that large populations of gay men take a daily pill as
prevention, or a technique known as pre-exposure prophylaxis (PrEP).
"Promoting PrEP to all men who have sex with men could be prohibitively
expensive," said Jessie Juusola, a PhD candidate in management science and
engineering in the Stanford School of Engineering and first author of the
"Adopting it for men who have sex with men at high risk of acquiring HIV,
however, is an investment with good value that does not break the bank."
Prescribing the pill generally to men who have sex with men in the United
States would cost $495 billion over 20 years, but targeting those at highest
risk only would bring costs down to $85 billion, said the study.
Looking out over the next two decades, researchers calculated a total of
490,000 new infections if PrEP is not used.
But if 20 percent of gay men take the pill daily, there would be nearly
63,000 fewer infections.
And if just 20 percent of high-risk men took the drug, 41,000 new
infections would be prevented over 20 years at a cost of about $16.6 billion.
Researchers used a measure of how long people live and their quality of
life, valued at $50,000 per year, versus the average costs of the pill and
doctor visits totaling about $10,000 per year.
"However, even though it provides good value, it is still very expensive,"
"In the current health-care climate, PrEP's costs may become prohibitive,
especially given the other competing priorities for HIV resources, such as
providing treatment for infected individuals."
Previous research has found the pill as prevention would not make financial
sense if taken for life, but the Stanford team said its formula differed
because it presumed just a 20-year period of pill-taking.
Truvada is currently available as a treatment for people with HIV in
combination with other anti-retroviral drugs.
Drug maker Gilead Sciences Inc. of California has filed a supplemental new
drug application to market it for prevention purposes.