Cost-Effective HIV PrEP: CAB-LA Transforms Prevention

Summary

Cabotegravir long-acting (CAB-LA) delivers a cost-effective HIV PrEP solution. It reduces infections and supports the Ending the HIV Epidemic (EHE) initiative. This review examines CAB-LA’s published economic and health benefits. It guides pharmaceutical executives and health policymakers to optimize PrEP strategies for diverse populations.

Why CAB-LA Excels in HIV Prevention

HIV remains a major U.S. public health issue. In 2019, nearly 37,000 new diagnoses occurred, disproportionately affecting underserved groups. Only 23% of eligible individuals use oral PrEP due to adherence challenges. Approved in 2021, CAB-LA outperforms oral PrEP. HPTN 083 and 084 trials show 66% and 88% reductions in HIV-1 acquisition for MSM/TGW and cisgender women, respectively. CAB-LA’s injectable format addresses adherence barriers, making it a game-changer.

How Cost-Effective Is CAB-LA?

CAB-LA proves cost-effective compared to generic oral FTC/TDF. It prevents 4.5 more HIV-1 infections per 100 PrEP users. This saves 0.2 quality-adjusted life-years (QALYs) per person. CAB-LA’s PrEP costs are higher ($54,631 vs. $4,028). Yet, it cuts HIV management costs by $42,517, adding $9,476 per person. The incremental cost-effectiveness ratio (ICER) is $46,843 per QALY, below the $100,000 threshold. Sensitivity analyses confirm stability. CAB-LA is cost-effective in 85% of simulations. It is cost-saving for cisgender women and African American/Black MSM, aligning with EHE goals.

Key Insights for Decision-Makers Looking for Cost-Effective HIV PrEP

• Superior Efficacy: CAB-LA reduces HIV-1 infections more effectively than oral FTC/TDF.
• Improved Adherence: Its every-2-month injections boost adherence and persistence by 20% over oral PrEP.
• Targeted Impact: CAB-LA saves costs for underserved groups, reducing HIV disparities.

Implications for Policy and Practice

• Health Economics: CAB-LA optimizes budgets where oral PrEP adherence is low.
• Health Outcomes: It lowers HIV-1 infections, enhancing quality of life and cutting long-term costs.
• Public Health Policy: Policymakers should expand CAB-LA access. This supports EHE goals by improving PrEP uptake.