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Potential impact and cost-effectiveness of long-acting injectable lenacapavir plus cabotegravir as HIV treatment in Africa

Article scientifique 2025 Anglais

Résumé

Although viral suppression is attained for most adults living with diagnosed HIV in East, Central, Southern and West Africa (ECSWA), challenges remain with sustained adherence to daily oral pill taking for some in the population. Here, we evaluate the potential effectiveness and cost-effectiveness of introduction of a new combination of long-acting injectable drugs of lenacapavir + cabotegravir to increase levels of sustained viral suppression. We find there is potential for a significant impact on HIV deaths and disability adjusted life years, including due to a decrease in mother to child transmission. If lenacapavir + cabotegravir can be sourced at a cost of around $ 80 per year or less, our analysis suggests there is potential for a policy to introduce it to be cost-effective in settings in ECSWA. Recognising the limitations of a modelling study, we suggest that implementation studies be conducted to confirm the viability of these approaches.

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Phillips, A., Smith, J., Bansi‐Matharu, L., Sikwese, K., Kityo, C., Flexner, C., Vitória, M., Ford, N., Doherty, M., Panos, Z., Ripin, D., Hickey, M., Havlir, D., Gandhi, M., Reid, M., Revill, P. (2025). Potential impact and cost-effectiveness of long-acting injectable lenacapavir plus cabotegravir as HIV treatment in Africa. https://doi.org/10.1038/s41467-025-60752-y

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Auteur(s)

Andrew Phillips Jennifer S. Smith Loveleen Bansi‐Matharu Kenly Sikwese Cissy Kityo Charles W. Flexner Marco Vitória Nathan P. Ford Meg Doherty Zack Panos David H. Brown Ripin Matthew D. Hickey Diane V. Havlir Monica Gandhi Michael Reid Paul Revill

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