Standard treatments for chronic Hepatitis B include interferon-alpha and lamivudine.
However, these are associated with adverse effects and viral resistance, respectively.
Dr Takeda and colleagues from England assessed the clinical effectiveness and cost-effectiveness of 2 alternative drugs for the treatment of adults with chronic Hepatitis B.
These 2 drugs included adefovir dipivoxil, and pegylated interferon-alpha-2a.
The research team undertook a systematic review, and economic evaluation of literature.
|Costs per quality adjusted life years were between $11,763 and $32,517|
|Journal of Viral Hepatitis|
The team searched electronic databases, including Cochrane Systematic Reviews and Medline, for literature that met criteria defined in a research protocol.
Retrieved articles were independently assessed for inclusion by 2 reviewers.
The researchers developed a Markov state transition model.
This model was used to estimate the cost-effectiveness of pegylated interferon-alpha-2a, and of adefovir dipivoxil.
The researchers compared these results with nonpegylated interferon-alpha-2a, lamivudine and best supportive care.
The team found 7 randomized controlled trials and 2 systematic reviews that met the inclusion criteria.
The researchers noted that adefovir dipivoxil was more effective than placebo or ongoing lamivudine in reducing levels of Hepatitis B virus DNA.
Rates of Hepatitis B e antigen seroconversion were higher among patients receiving adefovir dipivoxil than either placebo or ongoing lamivudine.
The team observed that treatment with pegylated interferon-alpha-2a showed reduced Hepatitis B virus DNA levels vs lamivudine monotherapy.
Hepatits B e antigen seroconversion rates at follow-up were higher for pegylated interferon-alpha-2a patients.
Dr Takeda's team concludes, “Results of our cost-effectiveness analysis demonstrate that incremental costs per quality adjusted life year for a range of comparisons were between $11,763(£5994) and $32,517 (£16,569).”
“These are within the range considered by National Health Service (NHS) decision-makers to represent good value for money.”