核苷类药物治疗慢性乙肝的药物经济学研究_吴斌.docVIP

Cost-effectiveness of Nucleoside Analogs Therapy for Hepatitis B: Markov cohort analyses in China Bin Wu 1, Jinfang Shen1,2 1Department of Pharmacy, Renji Hospital, affliated to School of Medicine, Shanghai Jiaotong University, Shanghai, China. 2Address correspondence to: Prof. Jinfang Shen, Department of Pharmacy, Renji Hospital, affliated to School of Medicine, Shanghai Jiaotong University, Dongfang Road 1600, Shanghai, China. Email: sjfsjtu@ This work was supported by the grant from Ministry of Science and Technology of the People’s Republic of China (NO.2008ZX09312-007) ABSTRACT Objectives: Chronic hepatitis B (CHB) resulted in heavy financial burden in China because of the 112 million people infected with hepatitis B. Current guidelines (ie, by AASLD, EASL and APASL) do not take into account the cost-effectiveness of nucleoside analogs therapy for Hepatitis B, several economic studies were conducted by the researchers from North America or Western Europe. The main purpose of the current study is to investigate the economic consequences of nucleoside analogs therapy (lamivudine, adefovir, telbivudine and entecavir) for Hepatitis B in China. Methods: The cost-utility analysis for HBeAg-positive and HBeAg-negative CHB was conducted from a third payer perspective over a lifetime time horizon using a Markov model, wihch tracked yearly patients’ transitions between different health states: chronic hepatitis B, HBeAg seroconversion (HBeAg-positive CHB has this special health state), CHB with resistance, virologic response, compensated cirrhosis, decompensated cirrhosis, hapetocelluar carcinoma, liver transplantation and death. The transition parameters were derived from systematic literature reviews or previous economic studies, and the cost and utility data were come from the studies based on Chinese CHB cohort. A 3% yearly discount rate was applied to both costs and health benefits.One-way sensitivity analyses, second-order Monte-Carlo and probabilistic sensi