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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]