WEDNESDAY, March 11, 2020 (HealthDay News) — Use of tenofovir alafenamide-emtricitabine (F/TAF) is not cost-effective compared with generic tenofovir disoproxil fumarate-emtricitabine (F/TDF) for HIV preexposure prophylaxis (PrEP) among men who have sex with men (MSM), according to a study published online March 10 in the Annals of Internal Medicine.

Rochelle P. Walensky, M.D., M.P.H., from Massachusetts General Hospital in Boston, and colleagues estimated the greatest possible clinical benefits and economic savings attributable to the improved safety profile of F/TAF and the maximum price payers would be willing to pay for F/TAF versus generic F/TDF among U.S. MSM using PrEP.

In the base-case analysis, the researchers found that for the 123,610 MSM receiving PrEP, during a five-year horizon, F/TAF averted 2,101 fractures and 25 cases of end-stage renal disease compared with F/TDF, with an incremental cost-effectiveness ratio (ICER) of more than $7 million per quality-adjusted life year (QALY). The maximum fair price for F/TAF was $8,670 per year at a 50 percent discount for generic F/TDF and a societal willingness to pay up to $100,000 per QALY. In the sensitivity analysis, the investigators found that the ICER for F/TAF remained more than $3 million per QALY among persons older than 55 years, and the maximum permissible fair price was $8,970 per year for F/TAF.

“At current F/TAF prices, F/TAF compared with generic F/TDF will not be cost-effective in the United States, even in populations at highest risk for F/TDF adverse events,” the authors write.

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