title: Cost-effectiveness analysis of antiviral therapies for hepatitis B e antigen-positive chronic hepatitis B patients in China.
abstract: OBJECTIVE
  Several antiviral therapies are now available for patients with chronic hepatitis B (CHB), but the most cost-effective strategy for Chinese patients is unclear. The aim of this study was to estimate the long-term cost effectiveness of the antiviral treatments (lamivudine, adefovir, telbivudine and entecavir) for hepatitis B e antigen (HBeAg)-positive CHB patients in China.
  
  
  METHODS
  A Markov model was used to simulate the life-time (41-year time span) costs and effectiveness associated with antiviral treatments from the perspective of Chinese healthcare. Relative model parameters were derived from Chinese population studies. Costs and effectiveness were discounted at 5 %. The highest retail prices for generic and branded drug prices were also considered. Probabilistic sensitivity analysis and one-way sensitivity analysis were used to explore model uncertainties.
  
  
  RESULTS
  In the base-case analysis, the least quality-adjusted life years (QALYs) were obtained with adefovir as the reference strategy. Lamivudine generated the highest incremental cost-effectiveness ratio (ICER), with an additional US$35,000 needed to gain one additional QALY for generic drugs and US$36,000 for branded drugs. Entecavir had the lowest ICER of US$7,600 and US$9,100, respectively. The projected 10-year cumulative incidences of compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma (HCC) and mortality for entecavir were lower than the other strategies. In probabilistic sensitivity analyses, entecavir was the preferred option at a threshold of US$18,924 per QALY.
  
  
  CONCLUSIONS
  In patients with HBeAg-positive CHB in China, entecavir is a cost-effective option compared with other therapies for CHB.
authors: Department of Epidemiology and Biostatistics and Guangdong Key Lab of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, Guangdong, China.
authors: Chi
authors: C
authors: Zhang
authors: Weixia
authors: W
authors: Ke
authors: Yanhui
authors: Y
authors: Gao
authors: Shudong
authors: S
authors: Zhou
authors: Li
authors: L
authors: Liu
authors: Xiaohua
authors: X
authors: Ye
authors: Zhenjiang
authors: Z
authors: Yao
authors: Yi
authors: Y
authors: Yang
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use*; D002681:China; D003362:Cost-Benefit Analysis; D006513:Hepatitis B e Antigens / Q000276:immunology* / Q000378:metabolism; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism / Q000821:virology*; D006801:Humans
chemical_list: D000998:Antiviral Agents; D006513:Hepatitis B e Antigens