Cost-effectiveness analysis of roadmap models in chronic hepatitis B using tenofovir as the rescue therapy
Background: The roadmap approach is recommended to guide chronic hepatitis B treatment. We evaluated the cost-effectiveness of various treatment strategies in the global market. Methods: Lamivudine and telbivudine were tested in roadmap models with switch-to tenofovir if HBV was detectable at week 2...
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| Format: | Article |
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International Medical Press
2010
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| author | Lui, Y.Y.N. Tsoi, K.K.F. Wong, V.W.S. Kao, J.H. Hou, J.L. Teo, E.K. Mohamed, R. Piratvisuth, T. Han, K.H. Mihm, U. Wong, G.L.H. Chan, H.L.Y. |
| author_facet | Lui, Y.Y.N. Tsoi, K.K.F. Wong, V.W.S. Kao, J.H. Hou, J.L. Teo, E.K. Mohamed, R. Piratvisuth, T. Han, K.H. Mihm, U. Wong, G.L.H. Chan, H.L.Y. |
| author_sort | Lui, Y.Y.N. |
| collection | UM |
| description | Background: The roadmap approach is recommended to guide chronic hepatitis B treatment. We evaluated the cost-effectiveness of various treatment strategies in the global market. Methods: Lamivudine and telbivudine were tested in roadmap models with switch-to tenofovir if HBV was detectable at week 24 or add-on tenofovir if resistance developed at year 1. Tenofovir and entecavir were tested as continuous monotherapy. In the reference arm, lamivudine was used with add-on tenofovir if resistance developed at year 1. The primary measure of effectiveness was undetectable HBV DNA at year 2. Cost-effectiveness was measured by incremental cost-effectiveness ratio (ICER) in US dollars against the reference arm. Results: In the US and Germany, costs of the reference arms were US $14,486 and US $9,998 for hepatitis B e antigen (HBeAg)-positive and US $11,398 and US $7,531 for HBeAg-negative patients, respectively. In HBeAg-positive patients, the lamivudine roadmap was most cost-effective (ICER US $15,260 in the US and US $29,113 in Germany) with comparable effectiveness (75.1%) to other strategies. In HBeAg-negative patients, tenofovir and entecavir monotherapies were most effective (91-96%) and cost-effective (ICER US $31,297-43,387 in the US and US $53,976-59,822 in Germany). In Asia, where telbivudine cost was lower, both telbivudine and lamivudine roadmaps were cost-effective in HBeAg-positive patients. Tenofovir would be most cost-effective in HBeAg-negative patients if its cost equaled that of telbivudine in Asia. Conclusions: In HBeAg-positive patients, lamivudine roadmap was most cost-effective; in Asia, telbivudine roadmap had comparable cost-effectiveness to lamivudine roadmap because of the relatively low price of telbivudine. In HBeAg-negative patients, entecavir and tenofovir monotherapies were more cost-effective than the roadmap models. |
| first_indexed | 2024-03-06T05:38:34Z |
| format | Article |
| id | um.eprints-15321 |
| institution | Universiti Malaya |
| last_indexed | 2024-03-06T05:38:34Z |
| publishDate | 2010 |
| publisher | International Medical Press |
| record_format | dspace |
| spelling | um.eprints-153212015-12-28T02:00:16Z http://eprints.um.edu.my/15321/ Cost-effectiveness analysis of roadmap models in chronic hepatitis B using tenofovir as the rescue therapy Lui, Y.Y.N. Tsoi, K.K.F. Wong, V.W.S. Kao, J.H. Hou, J.L. Teo, E.K. Mohamed, R. Piratvisuth, T. Han, K.H. Mihm, U. Wong, G.L.H. Chan, H.L.Y. R Medicine Background: The roadmap approach is recommended to guide chronic hepatitis B treatment. We evaluated the cost-effectiveness of various treatment strategies in the global market. Methods: Lamivudine and telbivudine were tested in roadmap models with switch-to tenofovir if HBV was detectable at week 24 or add-on tenofovir if resistance developed at year 1. Tenofovir and entecavir were tested as continuous monotherapy. In the reference arm, lamivudine was used with add-on tenofovir if resistance developed at year 1. The primary measure of effectiveness was undetectable HBV DNA at year 2. Cost-effectiveness was measured by incremental cost-effectiveness ratio (ICER) in US dollars against the reference arm. Results: In the US and Germany, costs of the reference arms were US $14,486 and US $9,998 for hepatitis B e antigen (HBeAg)-positive and US $11,398 and US $7,531 for HBeAg-negative patients, respectively. In HBeAg-positive patients, the lamivudine roadmap was most cost-effective (ICER US $15,260 in the US and US $29,113 in Germany) with comparable effectiveness (75.1%) to other strategies. In HBeAg-negative patients, tenofovir and entecavir monotherapies were most effective (91-96%) and cost-effective (ICER US $31,297-43,387 in the US and US $53,976-59,822 in Germany). In Asia, where telbivudine cost was lower, both telbivudine and lamivudine roadmaps were cost-effective in HBeAg-positive patients. Tenofovir would be most cost-effective in HBeAg-negative patients if its cost equaled that of telbivudine in Asia. Conclusions: In HBeAg-positive patients, lamivudine roadmap was most cost-effective; in Asia, telbivudine roadmap had comparable cost-effectiveness to lamivudine roadmap because of the relatively low price of telbivudine. In HBeAg-negative patients, entecavir and tenofovir monotherapies were more cost-effective than the roadmap models. International Medical Press 2010 Article PeerReviewed Lui, Y.Y.N. and Tsoi, K.K.F. and Wong, V.W.S. and Kao, J.H. and Hou, J.L. and Teo, E.K. and Mohamed, R. and Piratvisuth, T. and Han, K.H. and Mihm, U. and Wong, G.L.H. and Chan, H.L.Y. (2010) Cost-effectiveness analysis of roadmap models in chronic hepatitis B using tenofovir as the rescue therapy. Antiviral Therapy, 15 (2). pp. 145-155. |
| spellingShingle | R Medicine Lui, Y.Y.N. Tsoi, K.K.F. Wong, V.W.S. Kao, J.H. Hou, J.L. Teo, E.K. Mohamed, R. Piratvisuth, T. Han, K.H. Mihm, U. Wong, G.L.H. Chan, H.L.Y. Cost-effectiveness analysis of roadmap models in chronic hepatitis B using tenofovir as the rescue therapy |
| title | Cost-effectiveness analysis of roadmap models in chronic hepatitis B using tenofovir as the rescue therapy |
| title_full | Cost-effectiveness analysis of roadmap models in chronic hepatitis B using tenofovir as the rescue therapy |
| title_fullStr | Cost-effectiveness analysis of roadmap models in chronic hepatitis B using tenofovir as the rescue therapy |
| title_full_unstemmed | Cost-effectiveness analysis of roadmap models in chronic hepatitis B using tenofovir as the rescue therapy |
| title_short | Cost-effectiveness analysis of roadmap models in chronic hepatitis B using tenofovir as the rescue therapy |
| title_sort | cost effectiveness analysis of roadmap models in chronic hepatitis b using tenofovir as the rescue therapy |
| topic | R Medicine |
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