PUBLIC HEALTH IMPACT OF EXPANDING PREP UPTAKE AMONG SWISS MSM: A MICROSIMULATION MODEL COMPARING ORAL AND TWICE-YEARLY INJECTABLE REGIMENS
Author(s)
Turgay Ayer, Ph.D.1, Arkadius Gemlik, M.Sc.2, Emir Gursel, M.Sc.1, Matteo Mussi, M.A.2.
1Value Analytics Labs, Boston, MA, USA, 2Gilead Sciences Switzerland Sarl, Zug, Switzerland.
1Value Analytics Labs, Boston, MA, USA, 2Gilead Sciences Switzerland Sarl, Zug, Switzerland.
OBJECTIVES: Men who have sex with men (MSM) bear a disproportionate burden of HIV in Switzerland, with cantons such as Zurich and Geneva experiencing an even higher burden. Although oral pre-exposure prophylaxis (PrEP) is an effective prevention strategy, adherence challenges associated with daily use can limit its real-world effectiveness. Twice-yearly injectable PrEP, on the other hand, eliminates the need for daily adherence and provides sustained protection, potentially improving public health outcomes. To quantify the benefit of twice-yearly injectable PrEP, we evaluated the clinical outcomes of increasing oral versus twice-yearly injectable PrEP uptake in Switzerland.
METHODS: An HIV microsimulation model was developed to estimate the clinical impact of a 10% uptake increase in i) oral PrEP and ii) twice-yearly injectable PrEP among PrEP-naïve individuals in Switzerland. Evaluated populations included MSM aged 16-64 nationally, in Geneva, and in Zurich, as well as MSM aged 25-34 in Zurich. Model inputs included HIV incidence, disease progression, and PrEP utilization patterns (adherence, efficacy, and persistence) based on published data. The primary outcome was HIV cases averted per 10,000 individuals in 5 years.
RESULTS: Increasing oral PrEP uptake averted 2.3 HIV cases per 10,000 MSM aged 16-64 in Switzerland, 2.8 in Geneva, 3.7 in Zurich, and 7.1 among Zurich MSM aged 25-34 over 5 years. Twice-yearly injectable PrEP yielded higher reductions: 4.2, 5.9, 7.3, and 15.1 cases averted per 10,000 individuals over 5 years in the respective populations. Incremental reductions for injectable versus oral PrEP ranged from 1.9 to 8.0 per 10,000, with the greatest benefits in higher-incidence populations.
CONCLUSIONS: Increasing PrEP uptake among MSM in Switzerland results in substantial reductions in HIV cases, particularly in high-incidence subpopulations. Twice-yearly injectable PrEP provides additional reductions beyond oral PrEP, suggesting additional public health value and reduced burden on the healthcare system.
METHODS: An HIV microsimulation model was developed to estimate the clinical impact of a 10% uptake increase in i) oral PrEP and ii) twice-yearly injectable PrEP among PrEP-naïve individuals in Switzerland. Evaluated populations included MSM aged 16-64 nationally, in Geneva, and in Zurich, as well as MSM aged 25-34 in Zurich. Model inputs included HIV incidence, disease progression, and PrEP utilization patterns (adherence, efficacy, and persistence) based on published data. The primary outcome was HIV cases averted per 10,000 individuals in 5 years.
RESULTS: Increasing oral PrEP uptake averted 2.3 HIV cases per 10,000 MSM aged 16-64 in Switzerland, 2.8 in Geneva, 3.7 in Zurich, and 7.1 among Zurich MSM aged 25-34 over 5 years. Twice-yearly injectable PrEP yielded higher reductions: 4.2, 5.9, 7.3, and 15.1 cases averted per 10,000 individuals over 5 years in the respective populations. Incremental reductions for injectable versus oral PrEP ranged from 1.9 to 8.0 per 10,000, with the greatest benefits in higher-incidence populations.
CONCLUSIONS: Increasing PrEP uptake among MSM in Switzerland results in substantial reductions in HIV cases, particularly in high-incidence subpopulations. Twice-yearly injectable PrEP provides additional reductions beyond oral PrEP, suggesting additional public health value and reduced burden on the healthcare system.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH70
Topic
Clinical Outcomes, Epidemiology & Public Health, Health Service Delivery & Process of Care
Topic Subcategory
Public Health
Disease
Infectious Disease (non-vaccine), No Additional Disease & Conditions/Specialized Treatment Areas