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Data derived from published sources included: age-stratified HIV incidence\/100 person-years (PY) on- or off-PrEP (0.6\u201310.1 or 0.4\u20136.4), PrEP retention at 6 years (28%), transmissions by HIV RNA level (0.0\u201378.4\/100PY) and annual costs of antiretroviral therapy ($32 000\u201369 000), HIV care ($3100\u201334 600), and PrEP program\/generic drug ($900\/360). Outcomes included transmissions (percent of cohort infected), quality-adjusted life-years (QALYs), costs ($), and incremental cost-effectiveness ratios ($\/QALY). We explored the sensitivity of findings to variation in HIV incidence and drug prices.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared with annual screening alone, PrEP would increase QALYs (9.58 to 9.67), reduce new infections (37% to 30%), and decrease costs (by $5000) over 10 years. PrEP would remain cost-saving for HIV incidence off-PrEP \u22655.1\/100PY or annual PrEP price \u2264$1200. Over a lifetime horizon, PrEP would be cost-saving for HIV incidence off-PrEP \u22651.0\/100PY, across all retention assumptions examined. PrEP would not be cost-effective at HIV incidence \u22640.1\/100PY, regardless of drug price, due to programmatic costs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In US YMSM at increased risk of HIV, generic oral PrEP and every-3-month screening would be cost-saving compared with annual screening alone, even with high discontinuation and low adherence, over a range of HIV incidences.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciad566","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T14:46:07Z","timestamp":1697121967000},"page":"402-410","source":"Crossref","is-referenced-by-count":8,"title":["Daily Oral HIV Pre-exposure Prophylaxis Among Young Men Who Have Sex With Men in the United States: Cost-saving at Generic Drug Price"],"prefix":"10.1093","volume":"78","author":[{"given":"Alyssa K","family":"Amick","sequence":"first","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G Ege","family":"Eskibozkurt","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sybil G","family":"Hosek","sequence":"additional","affiliation":[{"name":"Stroger Hospital of Cook County , Chicago, Illinois , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare F","family":"Flanagan","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael J","family":"Landovitz","sequence":"additional","affiliation":[{"name":"UCLA Center for Clinical AIDS Research & Education , Los Angeles, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena Y","family":"Jin","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig M","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Alabama at Birmingham School of Public Health , Birmingham, Alabama , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth A","family":"Freedberg","sequence":"additional","affiliation":[{"name":"Medical Practice Evaluation Center, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Division of Infectious Diseases, Department of Medicine; Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital , Boston, Massachusetts , USA"},{"name":"Harvard Medical School , Boston, Massachusetts , USA"},{"name":"Department of Health Policy and Management, Harvard T. 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