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Economic evaluation of chronic hepatitis B treatments in Taiwan


  • Following publication of the HBeAg-positive and HBeAg-negative CHB pharmacoeconomic models in the Journal of Viral Hepatitis (2007), Laurence Lacey was subsequently contracted by GSK Taiwan to carry out an economic evaluation of CHB treatments in Taiwan using the models.

Dr Laurence Lacey, LaceySolutions Ltd, The Beaches, South Strand, Skerries, County Dublin, Ireland. Email:


Background and Aims:  Chronic hepatitis B (CHB) and its sequelae are major health problems in Taiwan. The purpose of the present study was the economic evaluation of short-duration treatments of CHB and longer duration antiviral treatment for up to 5 years.

Methods:  Ten-health state CHB disease progression Markov models were used for hepatitis B e antigen (HBeAg)-positive and HBeAg-negative CHB patients, respectively, that included the emergence of antiviral resistance. The perspective of this economic evaluation was the Taiwan health-care system. Costs and benefits were discounted at 3% per annum.

Results:  Short-course therapies of up to 1-year treatment had limited impact on improving patient survival. Long-term viral suppression with lamivudine and adefovir sequential rescue therapies (including add-on therapies) for up to 5 years were found to be highly cost-effective by international standards (estimated to be NT$580 000 per quality adjusted life year [QALY] for Taiwan). When Taiwan-specific model inputs were used for HBeAg-positive CHB, the cost per QALY for lamivudine plus adefovir sequential antiviral therapy increased by approximately 100% over the base-case estimate, but was still well within the estimated NT$580 000 per QALY threshold.

Conclusions:  In Taiwan, treatment of CHB patients with lamivudine and adefovir sequential antiviral therapies for up to 5 years results in survival benefits and is highly cost-effective.

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