[Pharmacoeconomic evaluation of treatments based on antiretrovirals for HBeAg-negative chronic hepatitis B].
OBJECTIVE
To evaluate long-term cost-effectiveness of nucleoside analogues and peg-interferon alfa-2a (peg-IFNa2a) for the treatment of chronic hepatitis B (CHB) in hepatitis B e antigen (HBeAg)-negative patients.


METHODS
A multi-health slate Markov model was developed based on the disease progression pattern to estimate the long-term effect and medical expense of different treatments for HBeAg-negative CHB.Incremental cost-effectiveness analysis was then carried out.


RESULTS
In comparison with no antiretroviral treatment, all of the antiretroviral treatments were capable of prolonging CHB patients' life years.In particular, entecavir plus adefovir dipivoxil combination therapy showed the best 2 year survival, with expected life-years and quality-adjusted life-years (QALYs) being 19.59 years and 10.12 years, respectively, which were 1.46 years and 1.12 years better than with no antiretroviral treatment. The most cost-effective treatment for HBeAg-negative CHB was lamivudine plus adefovir dipivoxil rescue therapy, as it prolonged survival by 0.95 QALYs with an additional 15459 yuan; the incremental medical cost for gaining 1 QALY was 16273 yuan.


CONCLUSIONS
Among the antiretroviral medicines applied as therapy for HBeAg-negative CHB in China, the most effective treatment is entecavir plus adefovir dipivoxil rescue therapy and the most cost-effective treatment is lamivudine plus adefovir dipivoxil rescue therapy.
Department of Infectious Diseases, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China.
Renjie
R
Ouyang
Xiaoguang
X
Ye
D000225:Adenine / Q000031:analogs & derivatives; D000998:Antiviral Agents; D002681:China; D003362:Cost-Benefit Analysis; D017850:Economics, Pharmaceutical; D006147:Guanine / Q000031:analogs & derivatives; D006513:Hepatitis B e Antigens; D019694:Hepatitis B, Chronic; D006801:Humans; D016898:Interferon-alpha; D019259:Lamivudine; D063065:Organophosphonates; D011092:Polyethylene Glycols; D019057:Quality-Adjusted Life Years; D011994:Recombinant Proteins
D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha; D063065:Organophosphonates; D011994:Recombinant Proteins; D019259:Lamivudine; D011092:Polyethylene Glycols; C413685:entecavir; D006147:Guanine; D000225:Adenine; C100416:peginterferon alfa-2a; C106812:adefovir dipivoxil