Table 5 HIV-related deaths, DALYs and costs over 50 years; cost-effectiveness analysis. Values are means over setting-scenarios
No lenacapavir + cabotegravir introduction | Lenacapavir + cabotegravir introduction | |
|---|---|---|
Difference in number of HIV-related deaths per year ^ | --- | -195 |
Difference in DALYs per year ^ | --- | -2400 |
Difference in annual cost ^ | --- | +$0.67 m |
Difference in net DALYs per year ^ | --- | -1060 |
Incremental cost-effectiveness ratio | --- | $ 280 |
Percent of setting scenarios for which policy incurs the lowest DALYs | 18% | 82% |
Percent of setting scenarios for which policy has the lowest cost | 85% | 16% |
Percent of setting scenarios for which policy has the lowest net DALYs (i.e. it is cost-effective) | 39% | 61% |
Incremental cost-effectiveness ratio according to total annual cost of lenacapavir + cabotegravir and clinic costs for delivery | ||
$ 100 | --- | $ 12 |
$ 140* | --- | $ 280 |
$ 180 | --- | $ 547 |
$ 220 | --- | $ 814 |
* cost used in primary analysis | ||
Incremental cost-effectiveness ratio according to the percentage of PWH on lenacapavir + cabotegravir who started when already virally suppressed (mean over 10 years). | ||
<20% | --- | $ 206 |
20%−39% | --- | $ 233 |
40%−59% | --- | $ 328 |
≥60% | --- | $ 434 |
Incremental cost-effectiveness ratio according to the percentage of PWH on lenacapavir + cabotegravir who started when on ART with viral non-suppression (mean over 10 years). | ||
<15% | --- | $ 466 |
15%–24.9% | --- | $ 293 |
25%–44.9% | --- | $ 197 |
≥45% | --- | $ 143 |
Incremental cost-effectiveness ratio according to the percentage of PWH on lenacapavir + cabotegravir who started when off ART (mean over 10 years). | ||
<30% | --- | $ 311 |
30%−44.9% | --- | $ 265 |
45%−59.9% | --- | $ 254 |
≥60% | --- | $ 280 |
Incremental cost-effectiveness ratio according to the percentage of PWH on ART who are on lenacapavir + cabotegravir (mean over 10 years). | ||
<10% | --- | $ 128 |
10%−14.9% | --- | $ 281 |
15%−19.9% | --- | $ 247 |
20%−24.9% | --- | $ 241 |
>25% | --- | $ 389 |
Incremental cost-effectiveness ratio according to HIV prevalence age15−49 | ||
<5% | --- | $ 448 |
5%−9.9% | --- | $ 316 |
10%−14.9% | --- | $ 339 |
15%−19.9% | --- | $ 209 |
20%−24.9% | --- | $ 236 |
≥ 25% | --- | $ 270 |
Incremental cost-effectiveness ratio according to HIV incidence (/100 person years) age 15−49 | ||
<0.15 | --- | $ 390 |
0.15 – 0.29 | --- | $ 450 |
0.30 – 0.44 | --- | $ 316 |
0.45 – 0.60 | --- | $ 331 |
0.60 – 0.75 | --- | $ 305 |
≥ 0.75 | --- | $ 213 |
Incremental cost-effectiveness ratio according to the percentage of PWH diagnosed | ||
< 80% | --- | $ 214 |
80%−84.9% | --- | $ 288 |
85%−89.9% | --- | $ 265 |
≥ 90% | --- | $ 288 |
Incremental cost-effectiveness ratio according to the percentage of diagnosed PWH on ART | ||
< 85% | --- | Cost-saving |
85%−89.9% | --- | $ 197 |
90%−94.9% | --- | $ 253 |
≥ 95% | --- | $ 327 |
Incremental cost-effectiveness ratio according to the percentage of PWH on ART with VL < 1000 cps/mL | ||
<85% | --- | Cost-saving |
85%−89.9% | --- | $ 96 |
90%−94.9% | --- | $ 221 |
≥ 95% | --- | $ 456 |
Incremental cost-effectiveness ratio according to the percentage of diagnosed PWH with VL > 1000 cps/mL | ||
<7% | --- | $ 627 |
7%−9.9% | --- | $ 457 |
10%−14.9% | --- | $ 288 |
15%−19.9% | --- | $ 157 |
≥ 20% | --- | $ 79 |
