Economic evaluation of HIV pre-exposure prophylaxis strategies: protocol for a methodological systematic review and quantitative synthesis

被引:1
作者
Thavorn, Kednapa [1 ,2 ,3 ]
Kugathasan, Howsikan [4 ]
Tan, Darrell H. S. [4 ,5 ]
Moqueet, Nasheed [4 ]
Baral, Stefan D. [6 ]
Skidmore, Becky [1 ]
MacFadden, Derek [7 ]
Simkin, Anna [4 ]
Mishra, Sharmistha [4 ,5 ,8 ,9 ]
机构
[1] Ottawa Hosp, Ottawa Hlth Res Inst, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada
[2] Univ Ottawa, Sch Epidemiol & Publ Hlth, Ottawa, ON, Canada
[3] ICES Ottawa, Inst Clin & Evaluat Sci, Ottawa, ON, Canada
[4] Univ Toronto, St Michaels Hosp, Ctr Urban Hlth Solut, Li Ka Shing Knowledge Inst, 209 Victoria St Rm 315,3rd Floor, Toronto, ON M5B 1T8, Canada
[5] Univ Toronto, Div Infect Dis, Dept Med, Toronto, ON, Canada
[6] Johns Hopkins Sch Publ Hlth, 615 N Wolfe St, Baltimore, MD 21205 USA
[7] Harvard Univ, Harvard TH Chan Sch Publ Hlth, 677 Huntington Ave, Boston, MA 02115 USA
[8] Univ Toronto, Inst Hlth Policy & Management, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada
[9] Univ Toronto, Inst Med Sci, Toronto, ON, Canada
基金
加拿大健康研究院;
关键词
Pre-exposure prophylaxis; Health economic evaluation; Methodological quality; HIV prevention; Mathematical models; HIV transmission models; Cost-effectiveness; Systematic review;
D O I
10.1186/s13643-018-0710-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Pre-exposure prophylaxis (PrEP) with antiretrovirals is an efficacious and effective intervention to decrease the risk of HIV (human immunodeficiency virus) acquisition. Yet drug and delivery costs prohibit access in many jurisdictions. In the absence of guidelines for the synthesis of economic evaluations, we developed a protocol for a systematic review of economic evaluation studies for PrEP by drawing on best practices in systematic reviews and the conduct and reporting of economic evaluations. We aim to estimate the incremental cost per health outcome of PrEP compared with placebo, no PrEP, or other HIV prevention strategies; assess the methodological variability in, and quality of, economic evaluations of PrEP; estimate the incremental cost per health outcome of different PrEP implementation strategies; and quantify the potential sources of heterogeneity in outcomes. Methods: We will systematically search electronic databases (MEDLINE, Embase) and the gray literature. We will include economic evaluation studies that assess both costs and health outcomes of PrEP in HIV-uninfected individuals, without restricting language or year of publication. Two reviewers will independently screen studies using predefined inclusion criteria, extract data, and assess methodological quality using the Philips checklist, Second Panel on the Cost-effectiveness of Health and Medicines, and the International Society for Pharmacoeconomics and Outcomes Research recommendations. Outcomes of interest include incremental costs and outcomes in natural units or utilities, cost-effectiveness ratios, and net monetary benefit. We will perform descriptive and quantitative syntheses using sensitivity analyses of outcomes by population subgroups, HIV epidemic settings, study designs, baseline intervention contexts, key parameter inputs and assumptions, type of outcomes, economic perspectives, and willingness to pay values. Discussion: Findings will guide future economic evaluation of PrEP strategies in terms of methodological and knowledge gaps, and will inform decisions on the efficient integration of PrEP into public health programs across epidemiologic and health system contexts.
引用
收藏
页数:7
相关论文
共 38 条
[1]  
[Anonymous], 2014, PREEXP PROPH PREV HI
[2]  
Australian Federation of AIDS Organization, 2016, AUSTR PREP ROUND
[3]   Pre-exposure prophylaxis as HIV prevention in the UK [J].
Brady, Michael .
THERAPEUTIC ADVANCES IN CHRONIC DISEASE, 2016, 7 (03) :150-152
[4]   Model Parameter Estimation and Uncertainty: A Report of the ISPOR-SMDM Modeling Good Research Practices Task Force-6 [J].
Briggs, Andrew H. ;
Weinstein, Milton C. ;
Fenwick, Elisabeth A. L. ;
Karnon, Jonathan ;
Sculpher, Mark J. ;
Paltiel, A. David .
VALUE IN HEALTH, 2012, 15 (06) :835-842
[5]   What do we know about the cost- effectiveness of HIV preexposure prophylaxis, and is it affordable? [J].
Cambiano, Valentina ;
Miners, Alec ;
Phillips, Andrew .
CURRENT OPINION IN HIV AND AIDS, 2016, 11 (01) :56-66
[6]  
Canadian Agency for Drugs and Technologies in Health (CADTH), 2017, HIV PREEXP PROPH EMT
[7]   High levels of adherence to a rectal microbicide gel and to oral Pre-Exposure Prophylaxis (PrEP) achieved in MTN-017 among men who have sex with men (MSM) and transgender women [J].
Carballo-Dieguez, Alex ;
Balan, Ivan C. ;
Brown, William, III ;
Giguere, Rebecca ;
Dolezal, Curtis ;
Leu, Cheng-Shiun ;
Marzinke, Mark A. ;
Hendrix, Craig W. ;
Piper, Jeanna M. ;
Richardson, Barbra A. ;
Grossman, Cynthia ;
Johnson, Sherri ;
Gomez, Kailazarid ;
Horn, Stephanie ;
Ayudhya, Ratiya Pamela Kunjara Na ;
Patterson, Karen ;
Jacobson, Cindy ;
Bekker, Linda-Gail ;
Chariyalertsak, Suwat ;
Chitwarakorn, Anupong ;
Gonzales, Pedro ;
Holtz, Timothy H. ;
Liu, Albert ;
Mayer, Kenneth H. ;
Zorrilla, Carmen ;
Lama, Javier ;
McGowan, Ian ;
Cranston, Ross D. .
PLOS ONE, 2017, 12 (07)
[8]  
Drummond MF., 2015, METHODS EC EVALUATIO
[9]   Model Transparency and Validation: A Report of the ISPOR-SMDM Modeling Good Research Practices Task Force-7 [J].
Eddy, David M. ;
Hollingworth, William ;
Caro, J. Jaime ;
Tsevat, Joel ;
McDonald, Kathryn M. ;
Wong, John B. .
VALUE IN HEALTH, 2012, 15 (06) :843-850
[10]   Effectiveness and safety of oral HIV preexposure prophylaxis for all populations [J].
Fonner, Virginia A. ;
Dalglish, Sarah L. ;
Kennedy, Caitlin E. ;
Baggaley, Rachel ;
O'Reilly, Kevin R. ;
Koechlin, Florence M. ;
Rodolph, Michelle ;
Hodges-Mameletzis, Ioannis ;
Grant, Robert M. .
AIDS, 2016, 30 (12) :1973-1983