Economic evaluation of treatments for chronic hepatitis B

Brazilian Journal of Infectious Diseases

Lenzi, Luana¹  Pontarolo, Roberto¹  Correr, Cassyano Januário¹  Venson, Rafael¹  Wiens, Astrid¹  Pedroso, Maria Lúcia Alves¹ 

[1] Universidade Federal do Paraná, Curitiba, Brazil

关键词: Chronic hepatitis B;    Economic evaluation;    Treatments;   

DOI  :  10.1016/j.bjid.2012.12.005

来源: Contexto

【 摘 要 】

The aim of this study was to conduct a cost-utility study of adefovir, entecavir, interferon alpha, pegylated interferon alpha, lamivudine and tenofovir for chronic hepatitis B in the context of Brazilian Public Health Care System. A systematic review was carried out for efficacy and safety. Another review was performed to collect utility data and transition probabilities between health states. A Markov model was developed in a time horizon of 40 years with annual cycles for three groups of: HBeAg positive, HBeAg negative, and all patients. These strategies were compared to a fourth group that received no treatment. Discount rates of 5% were applied and sensitivity analyses were performed. Tenofovir offered the best cost-utility ratio for the three evaluated models: U$397, U$385 and U$384 (per QALY, respectively, for HBeAg positive, negative, and all patients). All other strategies were completely dominated because they showed higher costs and lower effectiveness than tenofovir. The sequence of cost-utility in the three models was: tenofovir, entecavir, lamivudine, adefovir, telbivudine, pegylated interferon alpha, and interferon alpha. In the sensitivity analysis, adefovir showed lower cost-utility than telbivudine in some situations. The study has some limitations, primarily related to the creation of scenarios and modeling. In this study, tenofovir presented the best cost-utility ratio. The results obtained in this study will be valuable in decision-making and in the review of the clinical protocol, mainly involving the allocation of available resources for health care.

【 授权许可】

CC BY-NC-ND