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| Title: | Cost-Effectiveness of Peginterferon Alfa-2a Compared to Lamivudine Treatment in Patients with Hepatitis B E Antigen Positive Chronic Hepatitis B in Taiwan |
| Authors: | 陳培哲;張定宗;莊萬龍
CHEN, PEI-JER;CHANG, TING-TSUNG;CHUANG, WAN-LONG |
| Contributors: | 醫學研究部 |
| Date: | 2007 |
| Issue Date: | 2009-09-30T07:05:47Z |
| Abstract: | Background:Peginterferon alfa-2a (40KD), a new treatment option for patients with chronic hepatitis B (CHB), offers improved efficacy with a defined treatment duration compared with lamivudine, but at a higher cost. We undertook an economic evaluation of peginterferon alfa-2a from the perspective of the Taiwan Bureau of National Health Insurance to assess the clinical outcomes and costs of 48 weeks of peginterferon alfa-2a for the treatment of patients with hepatitis B e antigen (HBeAg)-positive CHB, compared to lamivudine treatment for 48 weeks. Methods: We performed a cost-effectiveness analysis using a state-transition Markov model simulating the natural history of HBeAg- positive CHB. Efficacy data were obtained from a randomized clinical trial of 820 patients (87% were Asian) comparing peginterferon alfa-2a to lamivudine. We modeled a hypothetical cohort of 32-year-old patients with HBeAg- positive CHB. Life expectancy, quality-adjusted life expectancy, lifetime costs ($NTD) and incremental cost- effectiveness ratios (ICER) were estimated. One-way sensitivity analyses were performed on all parameters in the model to evaluate uncertainty. Results: Treatment with peginterferon alfa-2a compared to lamivudine resulted in higher total costs, but longer quality-adjusted life expectancy, yielding an ICER of $NTD 381 000 ($US 12 000) per quality -adjusted life year (QALY) gained. Although there is uncertainty associated with the prognosis of HBeAg- positive CHB, the ICER did not exceed $NTD 485 000 ($US 15 000) per QALY gained despite variation in the parameters used in the analysis. Conclusions: Our analysis suggests that 48-week treatment with peginterferon alfa-2a compared to 48-week treatment with lamivudine in HBeAg-positive patients offers life expectancy and quality of life benefits at a favorable cost-effectiveness ratio. |
| Relation: | JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY v.22 n.9 pp.1494-1499 |
| Appears in Collections: | [附設醫院醫學研究部] Periodical Articles
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