| Revista: | Annals of hepatology |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000407813 |
| ISSN: | 1665-2681 |
| Autores: | Oyagüez, Itziar1 Buti, María2 Brosa, Max3 Rueda, Magdalena4 Casado, Miguel A1 |
| Instituciones: | 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 |
| Año: | 2017 |
| Periodo: | May-Jun |
| Volumen: | 16 |
| Número: | 3 |
| Paginación: | 358-365 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | 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 |
| Disciplinas: | Medicina |
| Palabras clave: | 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 |
| Texto completo: | Texto completo (Ver PDF) |
