Economic Evaluation of Oral Nucleos(t)ide Analogues for Patients with Chronic Hepatitis B in Thailand
Issued Date
2022-07-01
Resource Type
ISSN
11755652
eISSN
11791896
Scopus ID
2-s2.0-85124523627
Pubmed ID
35141850
Journal Title
Applied Health Economics and Health Policy
Volume
20
Issue
4
Start Page
587
End Page
596
Rights Holder(s)
SCOPUS
Bibliographic Citation
Applied Health Economics and Health Policy Vol.20 No.4 (2022) , 587-596
Suggested Citation
Dilokthornsakul P., Sawangjit R., Tangkijvanich P., Chayanupatkul M., Tanwandee T., Sukeepaisarnjaroen W., Sriuttha P., Permsuwan U. Economic Evaluation of Oral Nucleos(t)ide Analogues for Patients with Chronic Hepatitis B in Thailand. Applied Health Economics and Health Policy Vol.20 No.4 (2022) , 587-596. 596. doi:10.1007/s40258-022-00719-y Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/84526
Title
Economic Evaluation of Oral Nucleos(t)ide Analogues for Patients with Chronic Hepatitis B in Thailand
Other Contributor(s)
Abstract
Background: Nucleos(t)ide analogues (NAs) are the main drug category used in the treatment of chronic hepatitis B (CHB). There is a need to update the economic evaluation of CHB treatment. Objective: This study aimed to determine the cost effectiveness of NAs for CHB in Thailand. Method: We used a lifetime Markov model undertaken from a societal perspective. Tenofovir disoproxil fumarate (TDF), tenofovir alafenamide fumarate (TAF), entecavir (ETV) with TDF or TAF as rescue medications, and lamivudine (LAM) with TDF or TAF rescue medications were compared with best supportive care (BSC). We performed a network meta-analysis to estimate the treatment effects of each NA on hepatitis B surface antigen (HBsAg) loss in an Asian population and performed an additional literature review to identify inputs. We calculated incremental cost-effectiveness ratios (ICERs) per quality-adjusted life-years (QALYs) and performed sensitivity analyses. Results: Compared with BSC, all NAs could improve patients’ QALYs, with results ranging from 4.04 to 4.25 QALYs gained. TAF, TDF, LAM/TAF, and LAM/TDF yielded lower total lifetime costs than BSC, ranging from − $US1387 to − 814, whereas ETV/TAF and ETV/TDF yielded higher total lifetime costs than BSC, ranging from $US4965 to 4971. The ICER was $US1230/QALY for ETV/TDF and $US1228/QALY for ETV/TAF. Full incremental analysis showed that the ICER for LAM/TAF was $US1720/QALY compared with TAF. Conclusion: At current prices, TAF, TDF, LAM/TAF, and LAM/TDF are dominant options, and ETV/TAF or ETV/TDF are cost-effective options. LAM/TAF is the most cost-effective option, followed by TAF.