CROI 2015Researchers have estimated that preventing HIV in one high-risk individual saves an estimated $229,800 to $338,400 in lifetime medical costs. These figures update the researchers’ 2006 study that placed the savings at $361,400 in today’s dollars. The new, lowered estimate range accounts for differences in how soon people with HIV begin treatment and how consistently they remain in medical care and on antiretrovirals (ARVs). The findings were presented at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle.

“This study shows the continued value of HIV prevention, even in an era when people effectively treated with HIV medications can have a close-to-normal life expectancy,” Bruce Schackman, PhD, a professor of psychiatry and public health at Weill Cornell Medical College and the lead author of the study, said in a press release. “There is still significant value in avoiding infection, from both cost and quality of life points of view.”

The savings estimate is also lower than in the 2006 study because this time the researchers accounted for the fact that people with HIV are living longer, thus incurring greater medical costs. Additionally, a longer life means that, as they age, HIV-positive people will require medical care unrelated to the virus. So the researchers needed to subtract that figure from the estimated savings.

To make their estimate range, the researchers analyzed data from the Cost-Effectiveness of Preventing AIDS Complications model, along with data from the HIV Research Network.

The scientists devised two scenarios to represent patterns of HIV care in the United States for a theoretical person who contracts HIV at age 35. In the first, an individual’s entry into care after infection is delayed, and he or she does not always adhere to treatment or drops out of medical care. Secondly, in the best-case scenario, someone is put on treatment immediately after contracting the virus and remains in care indefinitely.
Preventing HIV in someone whose experience living with the virus would have followed the first scenario saved an estimated $326,500, according to the researchers’ model. For someone who fit the best-case scenario prototype, avoiding HIV saved $435,200. From these figures the researchers subtracted $96,700, the average lifetime medical costs of someone without HIV. This yielded the $229,800 to $338,400 estimate range. ($435,200-$96,700 is actually $338,500, but the researchers listed the figure as $338,400 because of rounding.)

“Recently, there has been an increased focus on new HIV prevention approaches,” said Schackman. “That focus on prevention approaches, including the use of PrEP [pre-exposure prophylaxis], led to our interest in determining the value of preventing an HIV infection.”