在日本对艾滋病毒暴露前预防的成本效益分析
Daisuke Mizushima1, Yoshino Nagai2, Dylan Mezzio3
1AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan.
Journal of medical economics
|July 8, 2023
概括
暴露前预防 (PrEP) 是日本与男性发生性关系的男性的经济有效的艾滋病毒预防策略. 每天使用PrEP可以减少感染和医疗费用,提供一种有价值的公共卫生干预措施.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 流行病学 流行病学
背景情况:
- 艾滋病毒疫情在全球范围内持续,与男性发生性关系的男性 (MSM) 面临高风险.
- 在其他地方,暴露前预防 (PrEP) 已被证明是具有成本效益的,但在日本,对于MSM而言未经批准或报销.
- 解决日本MSM中有效预防艾滋病毒的未满足需求至关重要.
研究的目的:
- 为了评估每日暴露前预防 (PrEP) 的成本效益,与在日本与男性发生性关系的男性 (MSM) 没有PrEP相比.
- 从国家医疗保健的角度,模拟PrEP对艾滋病毒感染和医疗保健成本的影响.
- 确定PrEP在日本所有47个县的经济可行性.
主要方法:
- 一项为期30年的成本效益分析,比较每日PrEP与没有PrEP的MSM.
- 将所有47个日本县的流行病学数据纳入模型.
- 计算的增量成本效益比率 (ICERs) 以质量调整后生命年 (QALY) 的成本为单位,包括敏感性分析.
主要成果:
- 在研究期间,PrEP使用可以预防日本MSM中48%至69%的HIV感染.
- 由于监测和一般医疗费用减少,每日PrEP在某些场景中被发现可以节省成本.
- 在47个县中的32个县,PrEP在每QALY支付5000万日元的愿意支付门上具有成本效益,PrEP成本是最敏感的因素.
结论:
- 每天服用一次PrEP是预防日本MSM感染艾滋病毒的成本效益高的策略.
- 实施PrEP可以显著减少日本艾滋病毒的临床和经济负担.
- 对日本MSM来说,PrEP是一个有价值的公共卫生干预措施,值得考虑批准和退款.
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