EXPANDING HIV PRE-EXPOSURE PROPHYLAXIS COULD REDUCE NEW HIV INFECTIONS BY 69% AND GENERATE LONG-TERM COST SAVINGS IN ITALY
Author(s)
Chiara Bini, -1, Valentina Mazzotta, -2, Silvia Nozza, -3, Martina Paoletti, -1, Virginia Scansetti, -1, Paolo Sciattella, -1.
1Economic Evaluation and HTA (EEHTA CEIS), Department of Economics and Finance, Faculty of Economics, Rome, Italy, 2Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy, 3Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
1Economic Evaluation and HTA (EEHTA CEIS), Department of Economics and Finance, Faculty of Economics, Rome, Italy, 2Clinical Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy, 3Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
OBJECTIVES: HIV infection remains a public health challenge in Italy, generating a significant clinical and economic burden despite high treatment coverage. Population ageing and the growing prevalence of comorbidities further increase this impact. Pre-exposure prophylaxis (PrEP) represents an effective primary prevention strategy. This study aimed to estimate the economic burden of HIV in Italy and to evaluate the clinical and economic impact of PrEP in a subgroup of population at high risk of HIV transmission (men who have sex with men - MSM).
METHODS: A prevalence-based Cost of Illness (COI) model was developed to estimate the economic burden of HIV in Italy, including both direct healthcare costs and indirect costs related to productivity losses. Additionally, a Cost-Consequence Analysis (CCA) using a Markov model simulated a closed cohort of 1,000 MSM with and without PrEP over a 20-year time horizon. In the PrEP scenario, the cohort reflected current Italian clinical practice, with 85% receiving oral PrEP with tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC), and 15% receiving long-acting injectable PrEP with lenacapavir. Epidemiological, clinical, and cost inputs were derived from literature, institutional sources, and expert opinion. Efficacy data for oral and injectable PrEP were sourced from the ANRS PREVENIR cohort and the PURPOSE-2 trial.
RESULTS: The annual cost of HIV management in Italy was estimated at approximately €994 million (€6,626 per person), with pharmaceutical costs representing the largest component (65%), followed by indirect costs (19%). In the simulated cohort of 1,000 MSM, PrEP reduced cumulative HIV infections over 20 years by about 69% compared with no PrEP, generating cumulative savings of approximately €32.8 million in direct costs related to newly diagnosed HIV cases.
CONCLUSIONS: Expanding PrEP use could significantly reduce new infections and future costs associated with long-term clinical management and antiretroviral treatment, improving the sustainability of healthcare resources.
METHODS: A prevalence-based Cost of Illness (COI) model was developed to estimate the economic burden of HIV in Italy, including both direct healthcare costs and indirect costs related to productivity losses. Additionally, a Cost-Consequence Analysis (CCA) using a Markov model simulated a closed cohort of 1,000 MSM with and without PrEP over a 20-year time horizon. In the PrEP scenario, the cohort reflected current Italian clinical practice, with 85% receiving oral PrEP with tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC), and 15% receiving long-acting injectable PrEP with lenacapavir. Epidemiological, clinical, and cost inputs were derived from literature, institutional sources, and expert opinion. Efficacy data for oral and injectable PrEP were sourced from the ANRS PREVENIR cohort and the PURPOSE-2 trial.
RESULTS: The annual cost of HIV management in Italy was estimated at approximately €994 million (€6,626 per person), with pharmaceutical costs representing the largest component (65%), followed by indirect costs (19%). In the simulated cohort of 1,000 MSM, PrEP reduced cumulative HIV infections over 20 years by about 69% compared with no PrEP, generating cumulative savings of approximately €32.8 million in direct costs related to newly diagnosed HIV cases.
CONCLUSIONS: Expanding PrEP use could significantly reduce new infections and future costs associated with long-term clinical management and antiretroviral treatment, improving the sustainability of healthcare resources.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE647
Topic
Clinical Outcomes, Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine), No Additional Disease & Conditions/Specialized Treatment Areas