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Economic Evaluation of Oral Nucleos(t)ide Analogues for Patients with Chronic Hepatitis B in Thailand

Author

Listed:
  • Piyameth Dilokthornsakul

    (Naresuan University)

  • Ratree Sawangjit

    (Mahasarakham University)

  • Pisit Tangkijvanich

    (Chulalongkorn University)

  • Maneerat Chayanupatkul

    (Chulalongkorn University)

  • Tawesak Tanwandee

    (Mahidol University)

  • Wattana Sukeepaisarnjaroen

    (Khon Kaen University)

  • Pajaree Sriuttha

    (Chiang Mai University)

  • Unchalee Permsuwan

    (Chiang Mai University)

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.

Suggested Citation

  • Piyameth Dilokthornsakul & Ratree Sawangjit & Pisit Tangkijvanich & Maneerat Chayanupatkul & Tawesak Tanwandee & Wattana Sukeepaisarnjaroen & Pajaree Sriuttha & Unchalee Permsuwan, 2022. "Economic Evaluation of Oral Nucleos(t)ide Analogues for Patients with Chronic Hepatitis B in Thailand," Applied Health Economics and Health Policy, Springer, vol. 20(4), pages 587-596, July.
    • Handle: RePEc:spr:aphecp:v:20:y:2022:i:4:d:10.1007_s40258-022-00719-y
    DOI: 10.1007/s40258-022-00719-y
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    Cited by:

    1. Siwaporn Niyomsri & Mantiwee Nimworapan & Wanwarang Wongcharoen & Piyameth Dilokthornsakul, 2023. "Economic Evaluation of Direct Oral Anticoagulants Compared to Warfarin for Venous Thromboembolism in Thailand: A Cost-Utility Analysis," IJERPH, MDPI, vol. 20(4), pages 1-15, February.

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