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

Author

Listed:
  • Andrew Phillips

    (University College London)

  • Jennifer Smith

    (University College London)

  • Loveleen Bansi-Matharu

    (University College London)

  • Kenly Sikwese

    (AfroCAB)

  • Cissy Kityo

    (Joint Clinical Research Centre)

  • Charles Flexner

    (Johns Hopkins University School of Medicine)

  • Marco Vitoria

    (WHO)

  • Nathan Ford

    (WHO)

  • Meg Doherty

    (WHO)

  • Zack Panos

    (Children’s Investment Fund Foundation)

  • David Ripin

    (Clinton Health Access Initiative)

  • Matthew Hickey

    (University of California San Francisco)

  • Diane Havlir

    (University of California San Francisco)

  • Monica Gandhi

    (University of California San Francisco)

  • Michael Reid

    (University of California San Francisco
    US Department of State’s Bureau of Global Health Security and Diplomacy – United States President’s Emergency Plan for AIDS Relief (PEPFAR))

  • Paul Revill

    (University of York)

Abstract

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.

Suggested Citation

  • Andrew Phillips & Jennifer Smith & Loveleen Bansi-Matharu & Kenly Sikwese & Cissy Kityo & Charles Flexner & Marco Vitoria & Nathan Ford & Meg Doherty & Zack Panos & David Ripin & Matthew Hickey & Dian, 2025. "Potential impact and cost-effectiveness of long-acting injectable lenacapavir plus cabotegravir as HIV treatment in Africa," Nature Communications, Nature, vol. 16(1), pages 1-13, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-60752-y
    DOI: 10.1038/s41467-025-60752-y
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