Table 1 Incremental cost-effectiveness of PrEP strategies over a 5-year time horizon.

	number of new infections	% of new infections averted	number of PrEP usage (person-year)	Discounted QALYG(1)	Plan A		Plan B		Plan C
	number of new infections	% of new infections averted	number of PrEP usage (person-year)	Discounted QALYG(1)	Discounted incremental cost, USD (2)	(2)/(1)	(2)	(2)/(1)	(2)	(2)/(1)
basecase	3450	/	0
non-targeting, 10%	2590	8%	17959	67	123458936	1842204	17294670	258064	9806914	146335
non-targeting, 30%	2048	23%	53910	212	370266861	1745524	51648582	243483	29176464	137545
non-targeting, 90%	942	55%	161936	526	1113780354	2115619	157156635	298518	89686050	170358
targeting, 10%	2754	3%	7629	24	52571166	2162072	7459389	306779	4277659	175926
targeting, 30%	2470	11%	22896	99	157200505	1583136	21831597	219862	12284040	123710
targeting, 90%	1780	31%	68752	287	472011282	1642874	65661580	228540	37001772	128788
test-and-treat	2075	23%	0	98	39055533	396874	39055533	396874	39055533	396874
non-targeting, 10%	1849	29%	17987	170	158411503	929215	52137608	305830	44642119	261863
non-targeting, 30%	1463	40%	53985	296	398568822	1345390	79665459	268915	57173233	192991
non-targeting, 90%	673	63%	162094	568	1127434311	1985645	170226003	299803	102714188	180901
targeting, 10%	1964	26%	7643	134	89432361	668940	44267840	331116	41082391	307290
targeting, 30%	1760	32%	22934	199	190572365	956132	55056540	276227	45498622	228274
targeting, 90%	1266	46%	68847	363	496573340	1366821	89865774	247356	61180726	168400

Plan A – market price for PrEP drug (annual cost of USD7880 at the end of 2017); Plan B – generic price for PrEP drug (annual cost of USD519); Plan C – zero cost for PrEP drug. All PrEP users are assumed to be in high adherence with an average of 87.5% usage per year. As we assume that 20% of high adherence users would change to low adherence users, whereas 10% of low adherence users would change to high adherence users in a year, a proportion of PrEP users would be in low adherence, with an average of 38% usage per year.
(2)/(1) = Discounted incremental cost-effectiveness (incremental $/QALYG).
Non-targeting – low-threshold approach with PrEP for both low- and high-risk MSM; targeting – PrEP for high-risk MSM only.
QALYG – quality-adjusted life-years gained.

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