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Chronic hepatitis B is a common disease associated with high morbidity, mortality and impact on healthcare costs.
Several oral antiviral therapies can lead to complete virologic response, which is associated with prevention of disease progression.
Dr Maria Buti and colleagues from Spain estimated the cost-effectiveness of the oral antiviral treatments lamivudine, adefovir, telbiv patients treated with one of the above drugs or no treatment.
Rescue therapy with 2 different combination therapies (adefovir plus lamivudine or tenofovir plus entecavir) with their corresponding costs and efficacy rates was also considered.
The probabilities of disease progression were based on serum Hepatitis B virus DNA levels.
Disease and complication costs were assessed using the perspective of the Spanish National Health System.
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| The highest rate of virologic response was obtained with tenofovir |
| Journal of Hepatology |
The researchers found that the highest rate of virologic response was obtained with tenofovir.
This translated to its higher life years saved and quality adjusted life years compared with the rest of the alternatives in Hepatitis B e antigen-positive and Hepatitis B e anitigen-negative patients.
Tenofovir is associated with lower costs and higher efficacy over entecavir, telbivudine and adefovir in Hepatitis B e antigen-positive patients, and telbivudine and entecavir in Hepatitis B e antigen-negative patients.
The incremental cost-effectiveness ratios with respect to the rest of the alternatives are below the common reference efficiency threshold of 30,000€ per life years saved /quality adjusted life years.
Dr Buti's team concluded, “In chronic HBV infected patients, tenofovir is a cost-effective or even cost-saving strategy compared with other available treatment options for chronic hepatitis B.”
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