Pharmacoeconomic evaluation of treatments based on antiretrovirals for HBeAg-negative chronic hepatitis B / 中华肝脏病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate long-term cost-effectiveness of nucleoside analogues and peg-interferon alfa-2a (peg-IFNa2a) for the treatment of chronic hepatitis B (CHB) in hepatitis B e antigen (HBeAg)-negative patients.</p><p><b>METHODS</b>A multi-health slate Markov model was developed based on the disease progression pattern to estimate the long-term effect and medical expense of different treatments for HBeAg-negative CHB.Incremental cost-effectiveness analysis was then carried out.</p><p><b>RESULTS</b>In comparison with no antiretroviral treatment, all of the antiretroviral treatments were capable of prolonging CHB patients' life years.In particular, entecavir plus adefovir dipivoxil combination therapy showed the best 2 year survival, with expected life-years and quality-adjusted life-years (QALYs) being 19.59 years and 10.12 years, respectively, which were 1.46 years and 1.12 years better than with no antiretroviral treatment. The most cost-effective treatment for HBeAg-negative CHB was lamivudine plus adefovir dipivoxil rescue therapy, as it prolonged survival by 0.95 QALYs with an additional 15459 yuan; the incremental medical cost for gaining 1 QALY was 16273 yuan.</p><p><b>CONCLUSION</b>Among the antiretroviral medicines applied as therapy for HBeAg-negative CHB in China, the most effective treatment is entecavir plus adefovir dipivoxil rescue therapy and the most cost-effective treatment is lamivudine plus adefovir dipivoxil rescue therapy.</p>