Economic evaluation of chronic hepatitis B treatments in Taiwan

Laurence Lacey*, Rong Nan Chien, Wan Long Chuang, Raoh Fang Pwu

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

15 Scopus citations

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 languageEnglish
Pages (from-to)571-579
Number of pages9
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume23
Issue number4
DOIs
StatePublished - 04 2008
Externally publishedYes

Keywords

  • Adefovir
  • Chronic hepatitis B
  • Cost-effectiveness
  • Lamivudine
  • Taiwan

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