Researchers at Emory's Rollins School of Public Health recommend price reductions of oral pre-exposure prophylaxis (PrEP) to increase use among individuals at risk of acquiring HIV. PrEP is a highly effective HIV prevention strategy used to decrease the number of new infections among men who have sex with men (MSM) in the United States.

Though effective, PrEP use is low largely due to cost barriers, with out-of-pocket fees of approximately $1,500 monthly. While many private insurance companies cover PrEP, high insurance premiums, deductibles, and co-payments can make PrEP unaffordable for low-income, high-risk individuals.  

"Lower pricing of PrEP drugs ensures that drug formularies include these medications in their top tiers not only for HIV treatment but also for prevention, and that PrEP medications are included on state Medicaid preferred drug lists," explains Jennie McKenney, PhD, post doctoral fellow at the Rollins School of Public Health.

McKenney and her team of researchers modified a previously published decision-analysis model to estimate the potential for cost effective PrEP strategies. Researchers measured the cost per quality-adjusted life year and the proposed PrEP drug cost required to meet specific cost-effectiveness thresholds. They also performed updated cost parameter estimates.

Results from the model revealed that if the price of PrEP were lowered by its manufacturer or with eventual generic manufacturing, cost savings for PrEP would likely be realized in most jurisdictions.

"Our results provide support for continued efforts to implement PrEP in MSM in the U.S.," says McKenney. "It also suggest that medication price reductions may play a pivotal role in reducing the incidence of HIV in this population.

The complete study is available in the June edition of PLoS One.