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Table 1 Benefits, costs and savings in healthcare costs of the individual and combined interventions, 2018~2037

From: A mathematical model of biomedical interventions for HIV prevention among men who have sex with men in China

 

Total infection over 20 years (2018~2037), million

HIV infections prevented over 20 years, million

HIV infections prevented over 20 years, %

HIV prevalence at 2037, %

HIV incidence rate at 2037, per 100 person-years

Incremental costs, Int.$ (billion)

Incremental QALYs, million

Average CER, Int.$/QALY, relative to base case

Saving in healthcare cost, Int.$ (billion)

Base case

0.78 (0.60–1.00)

–

–

11.2 (9.1–14.2)

0.73 (0.56–0.98)

–

–

–

–

Test and treat (90–90)

0.33 (0.28–0.39)

0.45 (0.28–0.62)

57.9% (46.4–66.5%)

5.8 (4.8–6.8)

0.24 (0.18–0.29)

2.13 (0.61–4.03)

1.22 (0.94–1.53)

1754 (462–3960)

8.86 (5.33–13.92)

PrEP-25% HRMSM

0.68 (0.57–0.87)

0.09 (0.06–0.14)

12.1% (8.7–16.7%)

9.8 (8.2–12.8)

0.61 (0.50–0.80)

3.08 (1.76–5.30)

0.18 (0.12–0.23)

17,277 (12,127–23,711)

1.73 (0.94–2.79)

PrEP-50% HRMSM

0.62 (0.52–0.80)

0.16 (0.10–0.23)

20.2% (15.1–26.9%)

8.9 (7.5–11.7)

0.53 (0.44–0.70)

5.34 (3.07–9.10)

0.30 (0.21–0.38)

17,979 (12,631–24,991)

2.87 (1.60–4.52)

PrEP-75% HRMSM

0.57 (0.49–0.75)

0.20 (0.13–0.29)

25.7% (19.6–33.3%)

8.4 (7.0–11.0)

0.47 (0.40–0.63)

6.98 (4.05–11.80)

0.38 (0.27–0.48)

18,452 (12,972–25,846)

3.64 (2.06–5.64)

Test+PrEP-25% HRMSM

0.53 (0.46–0.68)

0.24 (0.15–0.34)

30.8% (23.9–39.3%)

7.9 (6.8–10.2)

0.42 (0.36–0.53)

6.83 (4.39–10.62)

0.49 (0.37–0.61)

13,835 (9600–18,598)

4.36 (2.46–6.82)

Test+PrEP-50% HRMSM

0.46 (0.39–0.59)

0.32 (0.21–0.44)

41.0% (33.3–49.9%)

6.8 (5.8–8.8)

0.31 (0.26–0.40)

10.61 (6.65–16.76)

0.64 (0.48–0.78)

16,636 (11,595–22,919)

5.77 (3.37–8.86)

Test+PrEP-75% HRMSM

0.41 (0.35–0.53)

0.36 (0.25–0.49)

47.0% (39.3–55.6%)

6.2 (5.2–8.1)

0.25 (0.20–0.33)

13.20 (8.25–20.85)

0.73 (0.56–0.88)

18,110 (12,660–25,289)

6.64 (3.95–10.12)

Test and treat (90–90) + PrEP 25% HRMSM

0.24 (0.21–0.30)

0.53 (0.39–0.68)

68.3% (61.1–75.4%)

4.6 (3.7–5.6)

0.12 (0.08–0.15)

10.11 (7.42–13.49)

1.33 (1.12–1.69)

7574 (5166–10,243)

10.17 (6.30–16.33)

Test and treat (90–90) + PrEP 50% HRMSM

0.21 (0.18–0.26)

0.56 (0.43–0.72)

72.8% (66.6–78.7%)

4.1 (3.4–5.1)

0.09 (0.06–0.11)

14.69 (10.27–20.60)

1.40 (1.19–1.76)

10,485 (7199–14,484)

10.83 (6.82–17.25)

Test and treat (90–90) + PrEP 75% HRMSM

0.19 (0.16–0.24)

0.58 (0.45–0.74)

75.2% (69.7–80.5%)

3.9 (3.2–4.8)

0.07 (0.05–0.09)

17.63 (12.14–25.06)

1.44 (1.23–1.81)

12,218 (8415–16,992)

11.23 (7.13–17.81)

  1. PrEP pre-exposure prophylaxis, QALY quality-adjusted life years, CER cost-effectiveness ratio, Int.$ international dollars, HRMSM, high-risk MSM
  2. aInterventions that cost less than per capita gross domestic product (i.e., 15,943 Int.$) per QALYgained are defined as very cost effective [40]
  3. bInterventions that cost between one and three times per capita gross domestic product per QALY gained are defined as cost effective [40]