Potential population health outcomes and expenditures of HIV vaccination strategies in the United States

Long, Elisa F; Brandeau, Margaret L.; Owens, Douglas K

doi:10.1016/j.vaccine.2009.06.063

Cited by 31 publications

(35 citation statements)

References 61 publications

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“…The analysis relied heavily on the published model descriptions. Lack of information in any of the areas covered in this review may High-efficacy preventive vaccines that target high-risk groups 2010 [65] Use HSV-2 prevalence surveys to help monitor the extent of HIV infection 2010 [44] Transmission elimination…”

Section: Discussionmentioning

confidence: 99%

“…Anal sex was the main and often the only route of HIV transmission in the models. There were only three studies that included transmission through intravenous drug use in MSM [63][64][65] and none accounted for the effects of substance abuse in increasing risky sexual behaviour. Other characteristics were explored including temporal effects of changes in unprotected sexual practices [66], the effects of other sexually transmitted infections on HIV prevalence [67,68], and the relationship between perceptions on the future HIV epidemics and current sexual behaviour [69].…”

Section: Investigation Into Effects Of Hiv-transmission-related Charamentioning

confidence: 99%

“…The impact of an increase in unprotected sex as a consequence of ART has been repeatedly highlighted since early in the epidemic [32,[77][78][79]. New technologies for HIV prevention and control have been hypothetically evaluated before they even become available [21,22,65,[80][81][82][83]. Less commonly, mathematical models have been used in economic evaluations.…”

Section: Intervention Evaluationmentioning

confidence: 99%

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Mathematical models for the study of HIV spread and control amongst men who have sex with men

et al. 2011

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For a quarter of century, mathematical models have been used to study the spread and control of HIV amongst men who have sex with men (MSM). We searched MEDLINE and EMBASE databases up to the end of 2010 and reviewed this literature to summarise the methodologies used, key model developments, and the recommended strategies for HIV control amongst MSM. Of 742 studies identified, 127 studies met the inclusion criteria. Most studies employed deterministic modelling methods (80%). Over time we saw an increase in model complexity regarding antiretroviral therapy (ART), and a corresponding decrease in complexity regarding sexual behaviours. Formal estimation of model parameters was carried out in only a small proportion of the studies (22%) while model validation was considered by an even smaller proportion (17%), somewhat reducing confidence in the findings from the studies. Nonetheless, a number of common conclusions emerged, including (1) identification of the importance of assumptions regarding changes in infectivity and sexual contact rates on the impact of ART on HIV incidence, that subsequently led to empirical studies to gather these data, and (2) recommendation that multiple strategies would be required for effective HIV control amongst MSM. The role of mathematical models in studying epidemics is clear, and the lack of formal inference and validation highlights the need for further developments in this area. Improved methodologies for parameter estimation and systematic sensitivity analysis will help generate predictions that more fully express uncertainty, allowing better informed decision making in public health.

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Section: Discussionmentioning

confidence: 99%

Section: Investigation Into Effects Of Hiv-transmission-related Charamentioning

confidence: 99%

Section: Intervention Evaluationmentioning

confidence: 99%

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Mathematical models for the study of HIV spread and control amongst men who have sex with men

et al. 2011

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“…24,26 Using epidemiologic and behavioral data for South Africa, we estimate the health benefits and cost-effectiveness of alternative HIV intervention portfolios consisting of expanded ART, screening and counseling, voluntary male circumcision, vaginal microbicide use, and oral PrEP. We consider South Africa because of the extensive HIV disease burden there, although our modeling framework could be extended to other geographic settings or intervention programs.…”

Section: Model Overviewmentioning

confidence: 99%

Portfolios of Biomedical HIV Interventions in South Africa: A Cost-Effectiveness Analysis

Long

Stavert

2013

J GEN INTERN MED

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“…Previous economic evaluations have separately examined the cost-effectiveness of PrEP or HIV vaccines in the US, but none have modeled the potential outcomes when combining these products [18][19][20][21][22][23], as shown in a recent review of HIV vaccine cost-effectiveness studies [24]. For treatment of HIV, Truvada® is highly cost-effective when used in combination with other drugs, but the costeffectiveness estimates for prevention are mixed in reviews [21,25,26].…”

Section: Introductionmentioning

confidence: 99%

Potential Cost-Effectiveness of Pre-exposure Prophylaxis Combined with HIV Vaccines in the United States

Adamson¹,

Carlson²,

Kublin³

et al. 2017

Preprint

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This economic evaluation aims to support policy-making on the combined use of preexposure prophylaxis (PrEP) with HIV vaccines by evaluating the potential cost-effectiveness of implementation that would support the design of clinical trials for assessment of combined product safety and efficacy. The target study population is a cohort of men who have sex with men (MSM) in the United States. Policy strategies considered include standard HIV prevention, daily oral PrEP, HIV vaccine, and their combination. We constructed a Markov model based on clinical trial data and published literature. We used a payer perspective, monthly cycle length, a lifetime horizon, and a 3% discount rate. We assumed a price of $500 per HIV vaccine series in the base case. HIV vaccines dominated standard care and PrEP. At current prices,PrEP was not cost-effective alone or in combination. A combination strategy had the greatest health benefit but was not cost-effective (ICER=$463,448/QALY) as compared to vaccination alone. Sensitivity analyses suggest a combination may be valuable for higher-risk men with good adherence. Vaccine durability and PrEP drug prices were key drivers of cost-effectiveness. Results suggest that boosting potential may be key to HIV vaccine value.

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Potential population health outcomes and expenditures of HIV vaccination strategies in the United States

Cited by 31 publications

References 61 publications

Mathematical models for the study of HIV spread and control amongst men who have sex with men

Mathematical models for the study of HIV spread and control amongst men who have sex with men

Portfolios of Biomedical HIV Interventions in South Africa: A Cost-Effectiveness Analysis

Potential Cost-Effectiveness of Pre-exposure Prophylaxis Combined with HIV Vaccines in the United States

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