Cost-Effectiveness of a Statewide Pre-Exposure Prophylaxis Program for Gay, Bisexual, and Other Men Who Have Sex with Men

R I Med J (2013). 2019 Nov 1;102(9):36-39.


Pre-exposure prophylaxis (PrEP) is an effective tool for preventing HIV infection among men who have sex with men (MSM), but its cost-effectiveness has varied across settings. Using an agent-based model, we projected the cost-effectiveness of a statewide PrEP program for MSM in Rhode Island over the next decade. In the absence of PrEP, the model predicted an average of 830 new HIV infections over ten years. Scaling up the existing PrEP program to cover 15% of MSM with ten or more partners each year could reduce the number of new HIV infections by 33.1% at a cost of $184,234 per quality-adjusted life-year (QALY) gained. Expanded PrEP use among MSM at high risk for HIV infection has the potential to prevent a large number of new HIV infections but the high drug-related costs may limit the cost-effectiveness of this intervention.

Keywords: HIV pre-exposure prophylaxis; agent-based modeling; cost-effectiveness; men who have sex with men.

MeSH terms

  • Anti-HIV Agents / economics*
  • Anti-HIV Agents / therapeutic use*
  • Chemoprevention
  • Cost-Benefit Analysis
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • Health Care Costs
  • Homosexuality, Male*
  • Humans
  • Male
  • Pre-Exposure Prophylaxis / economics*
  • Pre-Exposure Prophylaxis / organization & administration
  • Quality-Adjusted Life Years
  • Rhode Island / epidemiology
  • Risk-Taking


  • Anti-HIV Agents