An economic evaluation of different treatments for HBeAg-positive chronic hepatitis B in China.
- Author:
Lacey LARRY
1
;
Xian-zhong LU
;
Tan ALISON
Author Information
- Publication Type:Journal Article
- MeSH: Adenine; analogs & derivatives; economics; therapeutic use; Antiviral Agents; economics; therapeutic use; Cost-Benefit Analysis; economics; Female; Hepatitis B e Antigens; blood; Hepatitis B, Chronic; blood; drug therapy; economics; Humans; Lamivudine; economics; therapeutic use; Male; Organophosphonates; economics; therapeutic use; Quality-Adjusted Life Years; Treatment Outcome
- From: Chinese Journal of Hepatology 2007;15(6):431-436
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo assess the economic evaluation of short- and long-term antiviral treatments of HBeAg-positive chronic hepatitis B from the perspective of the Chinese health care system.
METHODSA 10-health state Markov model was developed to estimate long-term cost and effectiveness of different treatments of HBeAg-positive CHB. Incremental cost-effectiveness analysis was then carried out.
RESULTSIn comparison with no antiviral treatment, lamivudine administered for 1-year was a highly cost-effective short-course treatment for HBeAg-positive CHB. However, of the treatments evaluated, lamivudine plus adefovir as a rescue medication or adefovir plus lamivudine as a rescue medication administered for 5 years resulted in a more sustained decrease in the rate of disease progression. In comparison with 1 year lamivudine treatment, the incremental cost per Quality Adjusted Life Year (QALY) for treatment with lamivudine plus adefovir or adefovir plus lamivudine as a rescue medication for 5 years was CNY 25 115 and 35 577 respectively, which was 55.2% and 36.5% lower than the estimated international threshold value for China.
CONCLUSIONIn comparison with no antiviral treatment, lamivudine administered for 1-year is a highly cost-effective short-course treatment. Longer duration antiviral treatments, lamivudine plus adefovir or adefovir plus lamivudine as a rescue medication are both cost-effective strategies, resulting in a more sustained decrease in the rate of disease progression.