Economic Evaluation of Drug Treatments for Patients with Chronic Hepatitis B (CHB): Results from a Systematic ReviewN. Tantai, U. Chaikledkaew*, P. Werayingyong and Y. Teerawattananon
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The treatment of chronic hepatitis B (CHB) could reduce liver inflammation and progression of hepatic cirrhosis and hepatocellular carcinoma which could prolong survival and improve quality of life of patients. The cost of treatment is very expensive; therefore economic evaluation studies are needed. This study aimed to review economic evaluation studies on drug treatment options for patients with CHB. Studies assessing both costs and outcomes of two or more drug treatments for patients with CHB were included. These studies published during 2000-2010 were searched through the Pubmed and Cochrane databases. The results showed that seventy-two abstracts were reviewed and only 26 articles were included. Most studies were analyzed based on the perspectives of health care system or third party payer which considered only direct medical costs. The outcomes were measured in terms of life years saved and/or quality-adjusted life year gained. Markov model was more frequently used compared to decision tree model. Probabilistic and one-way sensitivity analyses were mainly applied to test parameter uncertainty. Most studies showed that entecavir or pegylated interferon was more cost-effective compared with lamivudine. The results were relatively varied due to the differences in time horizon and variables used in the models such as drug resistance rate, efficacy on viral suppression, and drug prices. Moreover, most studies did not consider drugs’ side effects which could lead to higher costs and worse outcomes.
Keyword:
Chronic hepatitis B, economic evaluation, cost-effectiveness analysis, cost-utility analysis
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