Cost-Effectiveness and Clinical Impact of Antiviral Strategies of HBeAg-Positive and -Negative Chronic Hepatitis B



Document title: Cost-Effectiveness and Clinical Impact of Antiviral Strategies of HBeAg-Positive and -Negative Chronic Hepatitis B
Journal: Annals of hepatology
Database: PERIÓDICA
System number: 000407813
ISSN: 1665-2681
Authors: 1
2
3
4
1
Institutions: 1Pharmacoeconomics & Outcomes Research Iberia, Pozuelo de Alarcón, Madrid. España
2Hospital de la Vall d'Hebron, Barcelona. España
3Oblikue Consulting, Barcelona. España
4Gilead Sciences, Madrid. España
Year:
Season: May-Jun
Volumen: 16
Number: 3
Pages: 358-365
Country: México
Language: Inglés
Document type: Artículo
Approach: Analítico, descriptivo
English abstract Chronic hepatitis B (CHB) is associated with high burden and healthcare costs. Virologic response achieved with antivirals is associated with progression avoidance. This study aimed to estimate the efficiency and clinical impact of antiviral strategies in CHB patients. Material and methods. Material and methods. A Material and methods. Markov model estimated lifetime complications and direct costs in both, HBeAg-positive and HBeAg-negative cohorts. Strategy 1 (71% of treated population) and strategy 2 (100%), both based on pegylated interferon (peg-IFN) followed by oral tenofovir or entecavir, were compared to no treatment. Progression was based on HBV-DNA levels. Rescue therapy with oral antivirals was applied for peg-IFN failure. Disease costs (C, 2014) and utilities were obtained from literature. Results. Results. Results. Compared to natural history, strategy 1 increased QALY (3.98 in HBeAg-positive, 2.16 in -negative cohort). With strategy 2, survival was up to 5.60 (HBeAg-positive) and 3.05 QALY (in HBeAg-negative). The model predicted avoidance of 128 and 86 carcinomas in HBeAg-positive and -negative patients with strategy 1, and up to 181 and 121 in HBeAg-positive and -negative for strategy 2. Total cost increased up to C102,841 (strategy 1) and C105,408 (strategy 2) in HBeAg-positive, and C85,858 and C93,754 in HBeAg-negative. A C1,581/QALY gained ratio was estimated versus the natural history for both strategies. In conclusion, increasing antiviral coverage would be efficient, reducing complications
Disciplines: Medicina
Keyword: Gastroenterología,
Terapéutica y rehabilitación,
Hepatitis B,
Hepatitis crónica,
Terapia antiviral,
Peginterferón,
Costo-efectividad
Keyword: Medicine,
Gastroenterology,
Therapeutics and rehabilitation,
Hepatitis B,
Chronic hepatitis,
Antiviral therapy,
Peginterferon,
Cost-effectiveness
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