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Table 5 Variables used in model

From: Cost utility analysis of HIV pre exposure prophylaxis among men who have sex with men in Israel

  Source(s) and numbered text References
Intervention Costs
 PrEP daily first year 24,143 NIS [57], b
 PrEP daily subsequent years 23,565 NIS [57], b
 Current discount on PrEP cost 10%   Assumed
 Reduction for “PrEP on demand” 40.1% NIS [28, 29]
 Monitoring PrEP first year 4237 NIS a,b
 Monitoring PrEP subsequent years 3659 NIS a,b
 Monitoring PrEP first year 1810 NIS b
 Monitoring PrEP subsequent years 1312 NIS b
 Employment Losses - first year 1505 NIS [37, 39], a
 Employment Losses - subsequent years 1120 NIS [37, 39],a
Treatment Costs
 HIV Treatment Costs 94,759 NIS d
 monitoring NON_HAART -first year 5693 NIS a
 monitoring-NON HAART- subsequent years 12,845 NIS a
Disability Weights
 HIV negative (at age 36 years) 0.09   [39, 58, 59]
 HIV positive with HAART Rx 0.14   [18]
 HIV no HAART Rx 0.20   [18]
 AIDS with HAART Rx 0.15   [17, 19]
 AIDS no HAART Rx 0.29   [20, 21]
Epidemiology
 Excess Hospitalization Days per HIV case 1.74 per year [39], e
 HIV incidence rate trend among MSM (2011–2017) −5.20% per year f
 HIV to AIDS progression with HAART 0.08 per year [23, 24]
 HIV to AIDS progression without HAART 0.33 per year [23, 24]
 HAART efficacy in Israel 47.8%   1
 % HIV+ taking HAART 81.8%   f
 % HIV+ of high risk group who will take HAART 81.8%   f
 % of persons who were not taking HAART who start taking when they get AIDS 90%   f
Mortality Rates (%) per year
 HIV+ with ART- 40 yrs 0.007   [23, 26, 27]
 HIV+ with ART- 50 yrs 0.013   [23, 26, 27]
 HIV+ without ART- 40 yrs 0.040   [23, 28, 29]
 HIV+ without ART- 50 yrs 0.073   [23, 28, 29]
 AIDS+ with ART- 40 yrs 0.060   [23, 24, 26, 27]
 AIDS+ with ART- 50 yrs 0.067   [23, 24, 26, 27]
 AIDS+ without ART- 40 yrs 0.524   [23, 24, 28]
 AIDS+ without ART- 50 yrs 0.587   [23, 24, 28]
PreP efficacy
 Baseline RCT 86.0%   [4, 5]
 sensitivity analysis 78.5%   [2, 4, 5]
 sensitivity lower 90% 56.3%   [2, 4, 5]
 sensitivity upper 90% 90.0%   [2, 4, 5]
 open label trial 97.1%   [10]
 Coverage 100%   Assumed
 % of UAI MSM starting PrEP 80%   [47]
 % of non-UAI MSM starting PrEP 25%   Assumed
 % ofnon-UAI MSM PrEP who cease condom use 75%   Assumption
 Protection from condom use 80%   [32, 33]
 Transmission risk with condom 1.6% per act [32, 33]
 Transmission risk without condom 8.0% per act [32, 33]
 HIV cases per 100,000 high risk MSM 421.8   f
 HIV cases per 100,000 non-high risk MSM 84.4   f
Demographic
 Average age at HIV diagnosis 36.0 Years f
 Life expectancy at age of HIV diagnosis. 45.6 Years [39]
 Male population aged 18–69 (2018) 2,478,600   [39]
 MSM prevalence 3%   [8]
 MSM aged 18–69 78,013   [8, 39]
 Background Mortality - age-related eg: 40 yrs 0.001064   [39]
 Background Mortality - age-related eg: 50 yrs 0.002894   [39]
Economic
 Discount Rate 3% per annum [60]
 Average Employment Cost 165,592 NIS per annum [37, 39]
 Exchange Rate 3.595 USD to NIS [42]
 % makes 18–69 unemployed 7.1%   [39]
 Work losses due to PrEP monitoring yr 1 1505   [39]
 Work losses due to PrEP monitoring yr 2+ 1120   [39]
 Productivity losses due to HIV 23%   [38]
 % participating in labour force (age-related) 67–77%   [37, 39]
 Burial Costs 30,000 NIS Current cost
 General Hospital 2218 NIS per day b
 Emergency Room Visit 316 NIS b
 % work losses due to HIV aged 15–24 23.0%   [38]
 % work losses due to HIV aged 25–53 32.2%   [38]
 % work losses due to HIV aged 54+ 4.6%   [38]
 Absenteeism due to HIV treatment 23.3 hours per year [38], e
 Social Overheads on wages 23% NIS [38], e
 Wage Cost per Hour 71.31   [39]
 Male working hours 40.475 hours per week [37]
 GNP per capita 145,374 NIS [39, 41, 43]
  1. a) Ministry of Health protocols
  2. b) Ministry of Health prices
  3. c) HMO prices
  4. d) MOH reimbursement agreement with HMOs
  5. e) MOH Statistics Department
  6. f) MOH Department of TB and AIDS