{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:47:53Z","timestamp":1786978073713,"version":"build-2736575974"},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T00:00:00Z","timestamp":1695600000000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Curative therapies (CTx) to achieve durable remission of HIV disease without the need for antiretroviral therapy (ART) are currently being explored. Our objective was to model the long\u2010term health and cost outcomes of HIV in various countries, the impact of future CTx on those outcomes and the country\u2010specific value\u2010based prices (VBPs) of CTx.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed a decision\u2010analytic model to estimate the future health economic impacts of a hypothetical CTx for HIV in countries with pre\u2010existing access to ART (CTx+ART), compared to ART alone. We modelled populations in seven low\u2010and\u2010middle\u2010income countries and five high\u2010income countries, accounting for localized ART and other HIV\u2010related costs, and calibrating variables for HIV epidemiology and ART uptake to reproduce historical HIV outcomes before projecting future outcomes to year 2100. Health was quantified using disability\u2010adjusted life\u2010years (DALYs). Base case, pessimistic and optimistic scenarios were modelled for CTx+ART and ART alone. Based on long\u2010term outcomes and each country's estimated health opportunity cost, we calculated the country\u2010specific VBP of CTx.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The introduction of a hypothetical CTx lowered HIV prevalence and prevented future infections over time, which increased life\u2010years, reduced the number of individuals on ART, reduced AIDS\u2010related deaths, and ultimately led to fewer DALYs versus ART\u2010alone. Our base case estimates for the VBP of CTx ranged from $5400 (Kenya) up to $812,300 (United States). Within each country, the VBP was driven to be greater primarily by lower ART coverage, lower HIV incidence and prevalence, and higher CTx cure probability. The VBP estimates were found to be greater in countries where HIV prevalence was higher, ART coverage was lower and the health opportunity cost was greater.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results quantify the VBP for future curative CTx that may apply in different countries and under different circumstances. With greater CTx cure probability, durability and scale up, CTx commands a higher VBP, while improvements in ART coverage may mitigate its value. Our framework can be utilized for estimating this cost given a wide range of scenarios related to the attributes of a given CTx as well as various parameters of the HIV epidemic within a given country.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.26170","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T22:39:06Z","timestamp":1695681546000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The long\u2010term impact and value of curative therapy for HIV: a modelling analysis"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9095-1672","authenticated-orcid":false,"given":"Gregory F.","family":"Guzauskas","sequence":"first","affiliation":[{"name":"The Comparative Health Outcomes, Policy, and Economics Institute Department of Pharmacy University of Washington  Seattle Washington USA"},{"name":"HCD Economics  Daresbury UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy B.","family":"Hallett","sequence":"additional","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,25]]},"reference":[{"key":"e_1_2_24_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1904113"},{"key":"e_1_2_24_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-019-1841-8"},{"key":"e_1_2_24_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/hum.2020.252"},{"key":"e_1_2_24_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymthe.2021.05.024"},{"key":"e_1_2_24_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2019.04.011"},{"key":"e_1_2_24_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(20)30234-4"},{"key":"e_1_2_24_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41256-019-0107-1"},{"key":"e_1_2_24_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw120"},{"key":"e_1_2_24_10_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0342"},{"key":"e_1_2_24_11_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1025384819575"},{"key":"e_1_2_24_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.3021"},{"key":"e_1_2_24_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0010471"},{"issue":"7","key":"e_1_2_24_14_1","first-page":"793","article-title":"Value\u2010based pricing for emerging gene therapies: the economic case for a higher cost\u2010effectiveness threshold","volume":"25","author":"Garrison LP","year":"2019","journal-title":"J Manag Care Spec Pharm"},{"key":"e_1_2_24_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780190492939.001.0001"},{"key":"e_1_2_24_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X12455463"},{"key":"e_1_2_24_17_1","doi-asserted-by":"publisher","DOI":"10.2165\/11593050-000000000-00000"},{"key":"e_1_2_24_18_1","unstructured":"UNAIDS.HIV incidence per 1000 population\u2014adults (15\u201349).2020. Accessed 12 December 2022.https:\/\/aidsinfo.unaids.org"},{"key":"e_1_2_24_19_1","unstructured":"UNAIDS.AIDSinfo.2020. Accessed 12 December 2022.https:\/\/aidsinfo.unaids.org"},{"key":"e_1_2_24_20_1","unstructured":"US Census Bureau.International Database (IDB).2022. Accessed 12 December 2022.https:\/\/www.census.gov\/data\u2010tools\/demo\/idb\/#\/country?COUNTRY_YEAR=2022&COUNTRY_YR_ANIM=2022"},{"key":"e_1_2_24_21_1","unstructured":"National Institutes of Health.The stages of HIV infection. Accessed 12 December 2022.https:\/\/hivinfo.nih.gov\/understanding\u2010hiv\/fact\u2010sheets\/stages\u2010hiv\u2010infection"},{"key":"e_1_2_24_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69117-4"},{"key":"e_1_2_24_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030004"},{"key":"e_1_2_24_24_1","doi-asserted-by":"publisher","DOI":"10.1086\/590501"},{"key":"e_1_2_24_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60705-2"},{"key":"e_1_2_24_26_1","unstructured":"World Health Organization.Disability\u2010adjusted life years (DALYs). Accessed 12 December 2022.https:\/\/www.who.int\/data\/gho\/indicator\u2010metadata\u2010registry\/imr\u2010details\/158"},{"key":"e_1_2_24_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(15)00069-8"},{"key":"e_1_2_24_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2018-000964"},{"key":"e_1_2_24_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep22183"},{"key":"e_1_2_24_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01481-9"},{"key":"e_1_2_24_31_1","doi-asserted-by":"publisher","DOI":"10.2217\/rme-2020-0169"},{"key":"e_1_2_24_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymthe.2018.10.017"},{"key":"e_1_2_24_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-018-0990-4"},{"key":"e_1_2_24_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-017-0535-z"},{"key":"e_1_2_24_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healthpol.2010.02.005"},{"key":"e_1_2_24_36_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1425.011"},{"key":"e_1_2_24_37_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210497"},{"key":"e_1_2_24_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.7108"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.26170","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T08:20:35Z","timestamp":1699604435000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.26170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":37,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1002\/jia2.26170"],"URL":"https:\/\/doi.org\/10.1002\/jia2.26170","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9]]},"assertion":[{"value":"2023-01-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e26170"}}