Application of Bayesian Approach to Cost-Effectiveness Analysis of Antiviral Treatments in Chronic Hepatitis B

Abstract

BackgroundHepatitis B virus (HBV) infection is a major problem for public health; timely antiviral treatment can significantly prevent the progression of liver damage from HBV by slowing down or stopping the virus from reproducing. In the study we applied Bayesian approach to cost-effectiveness analysis, using Markov Chain Monte Carlo (MCMC) simulation methods for the relevant evidence input into the model to evaluate cost-effectiveness of entecavir (ETV) and lamivudine (LVD) therapy for chronic hepatitis B (CHB) in Jiangsu, China, thus providing information to the public health system in the CHB therapy.MethodsEight-stage Markov model was developed, a hypothetical cohort of 35-year-old HBeAg-positive patients with CHB was entered into the model. Treatment regimens were LVD100mg daily and ETV 0.5 mg daily. The transition parameters were derived either from systematic reviews of the literature or from previous economic studies. The outcome measures were life-years, quality-adjusted lifeyears (QALYs), and expected costs associated with the treatments and disease progression. For the Bayesian models all the analysis was implemented by using WinBUGS version 1.4.ResultsExpected cost, life expectancy, QALYs decreased with age. Cost-effectiveness increased with age. Expected cost of ETV was less than LVD, while life expectancy and QALYs were higher than that of LVD, ETV strategy was more cost-effective. Costs and benefits of the Monte Carlo simulation were very close to the results of exact form among the group, but standard deviation of each group indicated there was a big difference between individual patients.ConclusionsCompared with lamivudine, entecavir is the more cost-effective option. CHB patients should accept antiviral treatment as soon as possible as the lower age the more cost-effective. Monte Carlo simulation obtained costs and effectiveness distribution, indicate our Markov model is of good robustness.

Use Effectiveness of Medical Devices: A Case Study on the Deployment of Ultrasonographic Devices

“…The proposed set differs in the configuration of the individual ultrasonographic devices in relation to the individual departments (Table 3). At the same time, other methods can be used to solve the issue of ultrasonographic devices, such as probabilistic modeling of factors under uncertainty-Markov-state transition models, for example, Markovchain Monte Carlo [13][14][15] (or as fuzzy sets). 3 Possible risks of distortion of the result could arise when filling in the data in the questionnaire determining the performance of the devices by those who work with them.…”

Comparing Efficacy of Lamivudine, Adefovir Dipivoxil, Telbivudine, and Entecavir in Treating Nucleoside Analogues Naïve for HBeAg-Negative Hepatitis B with Medium Hepatitis B Virus (HBV) DNA Levels

“…Many patients with low viral load also choose ADV as antiviral drugs. ETV is superior to LMV in terms of virologic, biochemical, and histologic outcomes in NA-naive CHB patients, and is also superior in economic analysis [ 12 , 13 ]. However, the efficacy of antiviral drugs such as LMV, ADV, LdT, and ETV in the medium HBV DNA level in HBeAg-negative CHB patients is still unknown.…”

Bayesian Regression Model for a Cost-Utility and Cost-Effectiveness Analysis Comparing Punch Grafting Versus Usual Care for the Treatment of Chronic Wounds

“…Our CUA and CEA were carried out in a Bayesian framework [35][36][37][38][39][40][41][42]. A multiple regression analysis was conducted to verify if the results in costs, utility, and effectiveness could be explained by the treatment performed or by other covariates [43][44][45][46][47][48][49][50].…”