Cost-effectiveness analysis of lamivudine and adefovir dipivoxil in the treatment of patients with HBeAg-negative chronic hepatitis B
Article first published online: 16 JAN 2006
Alimentary Pharmacology & Therapeutics
Volume 23, Issue 3, pages 409–419, February 2006
How to Cite
BUTI, M., CASADO, M. A., CALLEJA, J. L., SALMERÓN, J., AGUILAR, J., RUEDA, M. and ESTEBAN, R. (2006), Cost-effectiveness analysis of lamivudine and adefovir dipivoxil in the treatment of patients with HBeAg-negative chronic hepatitis B. Alimentary Pharmacology & Therapeutics, 23: 409–419. doi: 10.1111/j.1365-2036.2006.02767.x
- Issue published online: 16 JAN 2006
- Article first published online: 16 JAN 2006
- Publication data Submitted 23 September 2005 First decision 28 September 2005 Resubmitted 1 November 2005 Resubmitted 11 November 2005 Accepted 15 November 2005
To estimate the cost-effectiveness over a 4-year duration of lamivudine and adefovir dipivoxil for patients with hepatitis B ‘e’ antigen-negative chronic hepatitis B.
A decision analysis model has been used to perform a cost-effectiveness analysis of lamivudine and adefovir dipivoxil from the perspective of the Spanish Public Health System. Data were obtained from clinical trials.
For the base-case, the total estimated cost per patient treated with lamivudine or adefovir dipivoxil for 4 years was €11 457 and €21 939 respectively. Virological response at year 4 for the lamivudine arm was 40.4% and 78.0% for the adefovir dipivoxil arm. The average cost-effectiveness ratio (cost per responding patient at year 4) was €28 375 for the lamivudine arm and €28 132 for the adefovir dipivoxil arm. The incremental cost-effectiveness ratio of adefovir dipivoxil vs. lamivudine (cost per additional responding patient with adefovir dipivoxil) was €27 872, demonstrating that this cost was slightly lower than the average cost-effectiveness ratios of adefovir dipivoxil or lamivudine. The sensitivity analysis demonstrated that the factors that most influence the cost-effectiveness were the response to adefovir dipivoxil and lamivudine at year 4.
Long-term treatment with adefovir dipivoxil is a cost-effective strategy in patients with chronic hepatitis B ‘e’ antigen-negative hepatitis.