{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:01:22Z","timestamp":1791460882333,"version":"4.3.4"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Long\u2010acting injectable cabotegravir (CAB\u2010LA) is superior to daily oral tenofovir disoproxil fumarate\/emtricitabine (TDF\/FTC) for HIV pre\u2010exposure prophylaxis (PrEP) and could expand PrEP usage. Given price differentials between CAB\u2010LA and TDF\/FTC, evaluating the cost\u2010effectiveness of potential PrEP coverage scenarios is warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We simulated PrEP coverage expansion among men who have sex with men (MSM) via introducing CAB\u2010LA using two age\u2010 and risk\u2010stratified HIV transmission models separately calibrated to local data from a high\u2010incidence (Atlanta, USA) and a low\u2010incidence (Montr\u00e9al, Canada) North American setting. PrEP coverage of HIV\u2010negative MSM was simulated to increase from 6% to 15%, 30%, 40% or 50% (Montr\u00e9al) or from 29% to 40% or 50% (Atlanta), within 5 or 10 years, with 0%, 15%, 30%, 50% or 100% of current TDF\/FTC users switching to CAB\u2010LA. Costing took a healthcare payer perspective and included PrEP pharmaceuticals, PrEP programmatic costs and HIV\u2010related care. Atlanta scenarios considered oral PrEP acquired at average recent market prices (primary analysis), and both settings modelled universal acquisition at the lowest available generic price (LAGP). Simulations were compared to baseline projections without CAB\u2010LA\u2010based expansions over 20 years, with costs and disability\u2010adjusted life years (DALYs) discounted 3% annually. Incremental cost\u2010effectiveness ratios (ICERs) of expansions were assessed against a $100,000 per DALY averted threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In Atlanta, scenario median ICERs at recent prices ranged from $141,600 (90% CI $60,100\u2212$256,000) to $203,800 ($99,300\u2212$359,200) per DALY averted. All uncertainty intervals covered $100,000. Under universal LAGP TDF\u2010FTC, median ICERs ranged from $255,800 ($112,900\u2212$452,30) to $370,700 ($172,200\u2212$669,100). The strongest expansion scenarios were expected to remain cost\u2010effective until approximately $2800\/dose, or approximately $1350 with universal LAGP TDF\/FTC. In Montr\u00e9al, scenarios had median ICERs from $920,000 to $2,540,000, excluding dominated runs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a high\u2010incidence Atlanta MSM population, CAB\u2010LA\u2010based PrEP expansions are not projected to be cost\u2010effective, though a minority of simulations achieved cost\u2010effectiveness. However, lower prices could achieve cost\u2010effectiveness. In a low\u2010incidence Montr\u00e9al MSM population, broad expansions are not expected to be cost\u2010effective at modelled prices. Prioritizing CAB\u2010LA to Montr\u00e9al MSM facing access, adherence or persistence barriers to oral PrEP warrants a cost\u2010effectiveness assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70061","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T08:36:38Z","timestamp":1768811798000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cost\u2010effectiveness of leveraging long\u2010acting injectable cabotegravir to expand PrEP coverage among MSM in two contrasting North American cities"],"prefix":"10.1002","volume":"29","author":[{"given":"Jesse A.","family":"Heitner","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Stansfield","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate M.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis School of Public Health, Imperial College London  London UK"},{"name":"HIV Prevention Trials Network Modelling Centre, Imperial College London  London UK"},{"name":"Department of Nursing and Community Health Glasgow Caledonian University London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla M.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Population and Global Health McGill University  Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael M.","family":"Milwid","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Population and Global Health McGill University  Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Moore","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah J.","family":"Donnell","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center  Seattle Washington USA"},{"name":"Department of Medicine Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqing","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Population and Global Health McGill University  Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu","family":"Maheu\u2010Giroux","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Population and Global Health McGill University  Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruanne V.","family":"Barnabas","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases Massachusetts General Hospital  Boston Massachusetts USA"},{"name":"Department of Medicine Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Claude","family":"Boily","sequence":"additional","affiliation":[{"name":"MRC Centre for Global Infectious Disease Analysis School of Public Health, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dobromir T.","family":"Dimitrov","sequence":"additional","affiliation":[{"name":"Fred Hutchinson Cancer Center  Seattle Washington USA"},{"name":"University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2101016"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00538-4"},{"key":"e_1_2_11_4_1","unstructured":"WorldwideRegistration: Cabotegravir PrEP [Internet]. 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