Economic efficiency of the alternative antiviral therapies for chronic Hepatitis B has not been systematically investigated and their quality remains unknown.
Professor You-Ping Ling and colleagues from China systematically reviewed economic evidence of antiviral therapies for chronic Hepatitis B.
The team searched 6 databases and 8 major journals supplemented with screening references of eligible studies.
|Adefovir salvage produced $8446 per quality-adjusted life years|
|Journal of Gastroenterology and Hepatology|
Full economic evaluations comparing alternative antiviral therapies in patients with chronic Hepatitis B virus infection were included.
The team reported that 2 investigators assessed the study quality and transferability, independently.
Data were analyzed qualitatively with adjustment when appropriate.
The researchers included 14 studies.
The team found that quality was high in 5 studies, moderate in 1 US and 5 Chinese studies, and low in 3 Chinese studies.
The major problems of quality are costing methods and analysis and the presentation of results.
The team found that in Australia and Poland, lamivudine-preferred strategies dominated interferon-alpha from the health-care sector perspective.
In the US, adefovir salvage produced US $8446 per additional quality-adjusted life years compared with interferon-alpha.
In Spain, the researchers observed that the cost of adefovir was US $34,840 for additional virological response.
In Taiwan, the use of pegylated interferon-alpha produced US $11,711 per additional quality-adjusted life years, compared with lamivudine.
In China, the incremental cost-effectiveness ratios of combination therapy lamivudine ranged from US $2860 to US $22,160 per additional loss of Hepatitis B e antigen.
The team noted that interferon-alpha versus lamivudine ranged from US $2490 to US $8890 per additional loss of Hepatitis B e antigen.
Professor Ling's team concluded, "The cost-effectiveness frontiers of treatment alternatives vary and are influenced by the comparators and socioeconomic conditions of countries."
"Lamivudine-containing therapy is cost-effective when newer antiviral agents were not available."
"Economic methods should be further improved in studies, particularly in China."