title: A novel estimation of the relative economic value in terms of different chronic hepatitis B treatment options.
abstract: BACKGROUND
  Prescribers, payors and healthcare decision-makers are increasingly examining the value of treatments. This study aims at analyzing economic value of chronic hepatitis B (CHB) treatment options, which are available in Korea.
  
  
  METHODS
  CHB infection was simulated using a health-state transition model with disease states defined as mild disease (Ishak F0/F1), fibrosis (F2/F3/F4), advanced fibrosis/cirrhosis (>F4), and complicated disease states (decompensated cirrhosis, hepatocellular carcinoma, liver transplant and death) based on available natural history data. The value of treatment-specific attributes on disease progression/regression was estimated based on published data in terms of events and costs avoided. 5-year treatment duration was assumed except for treatment initiation. Primary model output is the estimated cost savings of entecavir per patient per day of treatment versus the comparator in question for a given CHB patient.
  
  
  RESULTS
  The simulation of treating with entecavir versus no treatment predicted improved clinical outcomes for entecavir-treatment patients. In the long term, these clinical benefits translate into cost savings of $3.10 per day of treatment. In naive patient treatment, daily cost savings of using entecavir versus lamivudine or telbivudine was estimated at $2.89 and $1.72, respectively. In the case of suboptimal responders who pre-treated with lamivudine, daily cost saving for patients switching to entecavir was $1.38 per day of treatment compared to patients maintaining on lamivudine.
  
  
  CONCLUSIONS
  Entecavir exhibits characteristics of a favourable CHB treatment, which directly translates into economic and therapeutic value as opposed to either no treatment or alternative strategies.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Park
authors.forename: Jeong
authors.initials: J
authors.lastname: Heo
authors.forename: Tae Jin
authors.initials: TJ
authors.lastname: Lee
authors.forename: Hyung Joon
authors.initials: HJ
authors.lastname: Yim
authors.forename: Jong Eun
authors.initials: JE
authors.lastname: Yeon
authors.forename: Young-Suk
authors.initials: YS
authors.lastname: Lim
authors.forename: Min Jeong
authors.initials: MJ
authors.lastname: Seo
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Myung Seok
authors.initials: MS
authors.lastname: Lee
mesh_terms: D000998:Antiviral Agents / Q000191:economics / Q000627:therapeutic use; D003198:Computer Simulation; D017048:Health Care Costs; D019694:Hepatitis B, Chronic / Q000191:economics* / Q000473:pathology / Q000628:therapy; D006801:Humans; D017059:Models, Econometric; D015233:Models, Statistical; D056910:Republic of Korea; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents
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