Cost-Effectiveness Analysis of Antiviral Treatments for HBeAg-Positive Chronic Hepatitis B in Canada

He, Jing; Bowen, James M.; Xie, Feng; Goeree, Ron

doi:10.1016/j.jval.2012.06.005

Cited by 18 publications

(36 citation statements)

References 53 publications

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“…They concluded that tenofovir is a cost-effective strategy compared with other options for CHB. Jinghe[33] using Markov modeling conducted a cost-effectiveness analysis of LVD, telbivudine, ETV and tenofovir for CHB in Canada and concluded that compared with other therapies tenofovir generated the best results. Bin Wu [34] evaluated the economic consequences of LVD, ETV, adefovir, and telbivudine for CHB treatment in China, and concluded that ETV is the most cost-effective option when treating both HBeAg-positive and HBeAg-negative CHB patients.…”

Section: Discussionmentioning

confidence: 99%

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

2016

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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.

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Section: Discussionmentioning

confidence: 99%

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

2016

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“…Although guidelines recommend potent antivirals with a high barrier to resistance - entecavir and tenofovir - as first-line monotherapies, lamivudine is still one of the most preferred agents because of its inexpensive cost and excellent safety profile. Several studies from various countries have analyzed the cost-effectiveness of lamivudine and compared it with the other antiviral drugs [5,6,7,8]. They have all concluded that potent antivirals were much more cost effective than lamivudine treatment.…”

Section: Discussionmentioning

confidence: 99%

Lamivudine Treatment Failure Risks in Chronic Hepatitis B Patients with Low Viral Load

Köklü¹,

Gülşen

Tuna

et al. 2013

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Aim: To analyze the risk factors of lamivudine treatment failure (LTF) for the long-term use in patients with low viral load (LVL). Material and Methods: In this multicenter study, 548 antiviral naïve noncirrhotic adult patients with LVL (for HBeAg+ patients HBV DNA <10⁹ copies/ml and for HBeAg- patients HBV DNA <10⁷ copies/ml) were enrolled. As a control group, 46 lamivudine-initiated patients with high viral load (HVL) were included. Primary outcome was switching to or adding on another antiviral drug as a consequence of primary nonresponse, partial response, viral breakthrough or adverse events. Secondary outcomes included LTF rates at 1, 2, 3, 4 and 5 years and LTF-related viral and host factors. Results: Among 594 patients, 294 had to change lamivudine at the follow-up. Primary nonresponse, partial response, viral breakthrough or adverse events frequencies were 6.8, 1.6, 64.5 and 0.1%, respectively. Five-year LTF rates were 61.3 and 84.2% in patients with LVL and HVL, respectively. Among patients with LVL, patients with <100,000 copies/ml and ≥100,000 copies/ml had 54.8 and 67.3% LTF rates at the end of the 5th year, respectively. Logistic regression analysis of risk factors showed HBeAg+, hepatic activity index, HBV DNA, virological response at 6 months and duration of follow-up were independent predictors for LTF (p values were 0.001, 0.008, 0.003, 0.020 and 0.003, respectively). Conclusion: Similar to patients with HVL, first-line lamivudine therapy is not efficient for long-term use in patients with LVL. LTF risk is so high even in the absence of worse predictive factors.

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“…TDF is considered to have higher efficacy in Europe and America and has been recommended as one of the firstline treatments for CHB by several important associations dedicated to the study of the liver [5,9,10]. In developed countries some research indicates TDF may be the most cost-effective nucleos(t)ide treatment [11][12][13], mainly because of its low sale cost, excellent ability to suppress viral load, and the fact that no cases of virologic resistance have been observed. But whether TDF is also suitable for generalization for developing countries like China still remains uncertain.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of tenofovir disoproxil fumarate for treatment of chronic hepatitis B in China

Zhang

Liu

et al. 2016

Hepatol Int

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Cost-Effectiveness Analysis of Antiviral Treatments for HBeAg-Positive Chronic Hepatitis B in Canada

Abstract: Tenofovir generated the best results compared with all other therapies under evaluation.

Cited by 18 publications

References 53 publications

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

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

Lamivudine Treatment Failure Risks in Chronic Hepatitis B Patients with Low Viral Load

Cost-effectiveness analysis of tenofovir disoproxil fumarate for treatment of chronic hepatitis B in China

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