Cost–Utility Analysis of Tenofovir Alafenamide and Entecavir in Chronic Hepatitis B Patients: A Markov Decision Model
From the perspective of health economics, the evaluation of drug-related cost effectiveness and clinical utility is crucial. We conducted a cost–utility analysis of two first-line drugs, tenofovir alafenamide (TAF) and entecavir (ETV), in the treatment of chronic hepatitis B (CHB) patients. We perfo...
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MDPI AG
2024-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/4/813 |
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| author | Chun-Huang Lai Hon-Yi Shi Cheng-En Tsai Yuan-Chieh Yang Si-Un Frank Chiu |
| author_facet | Chun-Huang Lai Hon-Yi Shi Cheng-En Tsai Yuan-Chieh Yang Si-Un Frank Chiu |
| author_sort | Chun-Huang Lai |
| collection | DOAJ |
| description | From the perspective of health economics, the evaluation of drug-related cost effectiveness and clinical utility is crucial. We conducted a cost–utility analysis of two first-line drugs, tenofovir alafenamide (TAF) and entecavir (ETV), in the treatment of chronic hepatitis B (CHB) patients. We performed inverse probability of treatment weighting (IPTW) to match the independent variables between the two treatment groups. The incremental cost effectiveness ratio (ICER) of the two treatment groups was simulated using a decision tree with the Markov annual-cycle model. A total of 54 patients treated with TAF and 98 with ETV from January 2016 to December 2020 were enrolled. The total medical cost in the TAF group was NT$76,098 less than that in the ETV group, and TAF demonstrated more effectiveness than ETV by 3.19 quality-adjusted life years (QALYs). When the time horizon was set at 30 years, the ICER of the TAF group compared with the ETV group was −NT$23,878 per QALY, suggesting more cost savings for TAF. Additionally, with the application of TAF, over NT$366 million (approximately US$12 million) can be saved annually. TAF demonstrates cheaper medical costs and more favorable clinical QALYs than ETV. To balance health insurance benefits and cost effectiveness, TAF is the optimal treatment for CHB. |
| first_indexed | 2024-03-07T22:39:04Z |
| format | Article |
| id | doaj.art-d4683d4307704fa18ca2e8ef283ca815 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-07T22:39:04Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
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| series | Cancers |
| spelling | doaj.art-d4683d4307704fa18ca2e8ef283ca8152024-02-23T15:11:19ZengMDPI AGCancers2072-66942024-02-0116481310.3390/cancers16040813Cost–Utility Analysis of Tenofovir Alafenamide and Entecavir in Chronic Hepatitis B Patients: A Markov Decision ModelChun-Huang Lai0Hon-Yi Shi1Cheng-En Tsai2Yuan-Chieh Yang3Si-Un Frank Chiu4Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung 80457, TaiwanDepartment of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, TaiwanDivision of Gastroenterology, Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung 80457, TaiwanDepartment of Laboratory Medicine, Kaohsiung Municipal United Hospital, Kaohsiung 80457, TaiwanDepartment of Computer Science, Brown University, Providence, RI 02912, USAFrom the perspective of health economics, the evaluation of drug-related cost effectiveness and clinical utility is crucial. We conducted a cost–utility analysis of two first-line drugs, tenofovir alafenamide (TAF) and entecavir (ETV), in the treatment of chronic hepatitis B (CHB) patients. We performed inverse probability of treatment weighting (IPTW) to match the independent variables between the two treatment groups. The incremental cost effectiveness ratio (ICER) of the two treatment groups was simulated using a decision tree with the Markov annual-cycle model. A total of 54 patients treated with TAF and 98 with ETV from January 2016 to December 2020 were enrolled. The total medical cost in the TAF group was NT$76,098 less than that in the ETV group, and TAF demonstrated more effectiveness than ETV by 3.19 quality-adjusted life years (QALYs). When the time horizon was set at 30 years, the ICER of the TAF group compared with the ETV group was −NT$23,878 per QALY, suggesting more cost savings for TAF. Additionally, with the application of TAF, over NT$366 million (approximately US$12 million) can be saved annually. TAF demonstrates cheaper medical costs and more favorable clinical QALYs than ETV. To balance health insurance benefits and cost effectiveness, TAF is the optimal treatment for CHB.https://www.mdpi.com/2072-6694/16/4/813chronic hepatitis Btenofovir alafenamideentecavirinverse probability of treatment weightingcost–utility analysis |
| spellingShingle | Chun-Huang Lai Hon-Yi Shi Cheng-En Tsai Yuan-Chieh Yang Si-Un Frank Chiu Cost–Utility Analysis of Tenofovir Alafenamide and Entecavir in Chronic Hepatitis B Patients: A Markov Decision Model Cancers chronic hepatitis B tenofovir alafenamide entecavir inverse probability of treatment weighting cost–utility analysis |
| title | Cost–Utility Analysis of Tenofovir Alafenamide and Entecavir in Chronic Hepatitis B Patients: A Markov Decision Model |
| title_full | Cost–Utility Analysis of Tenofovir Alafenamide and Entecavir in Chronic Hepatitis B Patients: A Markov Decision Model |
| title_fullStr | Cost–Utility Analysis of Tenofovir Alafenamide and Entecavir in Chronic Hepatitis B Patients: A Markov Decision Model |
| title_full_unstemmed | Cost–Utility Analysis of Tenofovir Alafenamide and Entecavir in Chronic Hepatitis B Patients: A Markov Decision Model |
| title_short | Cost–Utility Analysis of Tenofovir Alafenamide and Entecavir in Chronic Hepatitis B Patients: A Markov Decision Model |
| title_sort | cost utility analysis of tenofovir alafenamide and entecavir in chronic hepatitis b patients a markov decision model |
| topic | chronic hepatitis B tenofovir alafenamide entecavir inverse probability of treatment weighting cost–utility analysis |
| url | https://www.mdpi.com/2072-6694/16/4/813 |
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