Analysis of the cost-effectiveness of antiviral therapies in chronic hepatitis B patients in Korea.
10.3350/kjhep.2009.15.1.25
- Author:
Byung Kook KIM
1
;
So Young KWON
;
Chang Hong LEE
;
Won Hyeok CHOE
;
Hong Mi CHOI
;
Hye Won KOO
Author Information
1. Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea. sykwonmd@hotmail.com
- Publication Type:Original Article ; English Abstract
- Keywords:
Chronic hepatitis B;
Antiviral agents;
Treatment outcome;
Cost effectiveness
- MeSH:
Adenine/*analogs & derivatives/economics/therapeutic use;
Antiviral Agents/*economics/therapeutic use;
Cohort Studies;
Cost-Benefit Analysis;
Drug Therapy, Combination;
Hepatitis B e Antigens/blood;
Hepatitis B, Chronic/drug therapy/*economics;
Humans;
Interferon-alpha/*economics/therapeutic use;
Korea;
Lamivudine/*economics/therapeutic use;
Models, Statistical;
Phosphonic Acids/*economics/therapeutic use;
Quality of Life;
Severity of Illness Index
- From:The Korean Journal of Hepatology
2009;15(1):25-41
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The purpose of this study was to evaluate the cost-effectiveness of 1 year and up to 5 years of antiviral treatment for chronic hepatitis B (CHB). METHODS: Two ten-health-state Markov models were developed for CHB patients. The proportion of patients remaining alive in each health state, and healthcare costs and quality-adjusted life years (QALYs) were determined during annual cycles of these Markov models. The total healthcare costs, life years, and QALYs over the 40-year time horizon of the model were calculated. The perspectives of the cost-effectiveness analysis were the Korean healthcare system and the healthcare needs of the CHB patient. RESULTS: Short-course therapy with alpha-interferon or 1-year treatment with pegylated interferon alpha-2a, lamivudine (LMV), or adefovir (ADV) had limited impact on disease progression. In contrast, either LMV-ADV or ADV-LMV as rescue medication administered for 5 years resulted in a more sustained decrease in the rate of disease progression. The cost-effectiveness threshold in Korea was estimated to be approximately 25,000,000 South Korean won. LMV administered for 1 year is cost-effective in comparison with no treatment for both HBeAg-positive and HBeAg-negative CHB patients, but longer duration antiviral therapies administered for up to 5 years in CHB patients were found to be highly cost-effective by international standards. CONCLUSIONS: Antiviral treatment of CHB with LMV or ADV for up to 5 years using the alternative antiviral agent as rescue medication appears to be a cost-effective strategy for both HBeAg-positive and HBeAg-negative CHB patients in Korea. Economic evaluation of antiviral therapies should be studied further and updated, particularly for newer agents.
