Abstract
Background and Aims: Chronic hepatitis B (CHB) and its sequelae are major health problems in Taiwan. The purpose of the present study was the economic evaluation of short-duration treatments of CHB and longer duration antiviral treatment for up to 5 years. Methods: Ten-health state CHB disease progression Markov models were used for hepatitis B e antigen (HBeAg)-positive and HBeAg-negative CHB patients, respectively, that included the emergence of antiviral resistance. The perspective of this economic evaluation was the Taiwan health-care system. Costs and benefits were discounted at 3% per annum. Results: Short-course therapies of up to 1-year treatment had limited impact on improving patient survival. Long-term viral suppression with lamivudine and adefovir sequential rescue therapies (including add-on therapies) for up to 5 years were found to be highly cost-effective by international standards (estimated to be NT$580 000 per quality adjusted life year [QALY] for Taiwan). When Taiwan-specific model inputs were used for HBeAg-positive CHB, the cost per QALY for lamivudine plus adefovir sequential antiviral therapy increased by approximately 100% over the base-case estimate, but was still well within the estimated NT$580 000 per QALY threshold. Conclusions: In Taiwan, treatment of CHB patients with lamivudine and adefovir sequential antiviral therapies for up to 5 years results in survival benefits and is highly cost-effective.
Original language | English |
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Pages (from-to) | 571-579 |
Number of pages | 9 |
Journal | Journal of Gastroenterology and Hepatology (Australia) |
Volume | 23 |
Issue number | 4 |
DOIs | |
State | Published - 04 2008 |
Externally published | Yes |
Keywords
- Adefovir
- Chronic hepatitis B
- Cost-effectiveness
- Lamivudine
- Taiwan