Stanford University researchers have concluded that a once a day pill designed to prevent the spread of HIV could prove cost effective for high risk members of the population. The drug, known as tenofovir-emtricitabine, reduces the risk of HIV infection by nearly fifty percent in a 2010 clinical trial, and the test subjects who reported taking the pill religiously, had upwards of seventy percent reduction in HIVB infection.
The pill, which is sold under the brand name Truvada, is also used for treating those already infected with HIV, but a landmark study in 2010 proved it effective for preventing the spread of the disease. The drug’s maker, Foster City, Calif.-based Gilead Sciences Inc., has filed a supplemental new drug application to allow its use for prevention purposes.
The scientists at Stanford were interested to see whether giving the pill to large tracts of the population would be cost effective. The prevention technique, known as pre-exposure prophylaxis, or PrEP, simply aims to prevent the spread rather than cure the virus. By focusing on men who have sex with other men (MSM), who account for more than half of the estimated 56,000 new HIV infections each year, they were able to create an economic model for PrEP.
Jessie Juusola, a PhD candidate in management science and engineering in the School of Engineering and first author of the study said :
“Promoting PrEP to all men who have sex with men could be prohibitively expensive … 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.”
The study, published in The Annals of Internal Medicine, shows that giving the pill to the general MSM population would cost nearly $500 Billion, whereas targeting only high risk sectors drops the price by more than 80%. In the past, it was not thought that giving the pill would be possible due to high costs, but the Stanford study takes a new approach.
The team went on to estimate the costs of the pill, which comes in at $26 a day and spread over time would produce a $50,000 per quality-adjusted life year. Jusola continues that :
“… 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.”
The study doesn’t make clear whether the costs per dose would be reduced by manufacturing and distributing it in large quantities, although there is a study underway to see whether the drug can be effective if taken less often, which obviously reduces some costs. Others have commented and questioned the intelligence of giving a drug which does have some possible toxicity and side effects in such large quantities.
Written by Rupert Shepherd