[Pharmacoeconomic evaluation of treatments based on antiretrovirals for HBeAg-negative chronic hepatitis B].

Objective To evaluate long-term cost-effectiveness of nucleoside analogues and peg-interferon alfa-2a (peg-IFNα2a) for the treatment of chronic hepatitis B (CHB) in hepatitis B e antigen (HBeAg)-negative patients. Methods A multi-health state Markov model was developed based on the disease progression pattern to estimate the long-term effect and medical expense of different treatments for HBeAg-negative CHB. Incremental cost-effectiveness analysis was then carried out. Results In comparison with no antiretroviral treatment, all of the antiretroviral treatments were capable of prolonging CHB patients' life years. In particular, entecavir plus adefovir dipivoxil combination therapy showed the best 2 year survival, with expected life-years and quality-adjusted life-years (QALYs) being 19.59 years and 10.12 years, respectively, which were 1.46 years and 1.12 years better than with no antiretroviral treatment. The most cost-effective treatment for HBeAg-negative CHB was lamivudine plus adefovir dipivoxil rescue therapy, as it prolonged survival by 0.95 QALYs with an additional 15459 yuan; the incremental medical cost for gaining 1 QALY was 16273 yuan. Conclusion Among the antiretroviral medicines applied as therapy for HBeAg-negative CHB in China, the most effective treatment is entecavir plus adefovir dipivoxil rescue therapy and the most cost-effective treatment is lamivudine plus adefovir dipivoxil rescue therapy. Key words: Hepatitis B, chronic; Pharmacoeconomic; Markov model; Nucleositde analogue; Interferon alfa-2a