BACKGROUND: Chronic hepatitis B is a common, progressive disease, particularly when viral replication is detected. Oral antivirals can suppress viral replication and prevent or delay the development of cirrhosis and liver-related complications. OBJECTIVE: The aim of this study was to systematically review the quality of cost-effectiveness evidence on first-line treatment with entecavir (ETV) or tenofovir difumarate (TDF) for patients with chronic hepatitis B. METHODS: We searched electronic databases and retrieved articles published up to October 2011, in which the cost effectiveness of ETV or TDF was compared with that of other oral antivirals. The quality of the studies identified was assessed with a standard checklist for critical appraisal. RESULTS: We selected 16 original papers, all published in the last 5 years. There was a conflict of interest in 12 of the 16 studies due to sponsorship by the corresponding pharmaceutical companies. According to the validity assessment, ten studies were classified as high quality. Five studies performed a cost-effectiveness analysis comparing ETV with TDF; they concluded that TDF dominates ETV. The other 11 studies compared ETV or TDF with other strategies; all concluded that ETV and TDF are both cost-effective interventions. CONCLUSIONS: This systematic review shows that there is valid evidence suggesting that ETV and TDF are cost-effective interventions for the treatment of patients with chronic hepatitis B in many health systems. In countries where both alternatives are available, it appears that TDF dominates ETV. These results could help decision makers and clinicians to understand economic issues regarding the available drugs for first-line treatment of hepatitis B.
BACKGROUND: Chronic hepatitis B is a common, progressive disease, particularly when viral replication is detected. Oral antivirals can suppress viral replication and prevent or delay the development of cirrhosis and liver-related complications. OBJECTIVE: The aim of this study was to systematically review the quality of cost-effectiveness evidence on first-line treatment with entecavir (ETV) or tenofovir difumarate (TDF) for patients with chronic hepatitis B. METHODS: We searched electronic databases and retrieved articles published up to October 2011, in which the cost effectiveness of ETV or TDF was compared with that of other oral antivirals. The quality of the studies identified was assessed with a standard checklist for critical appraisal. RESULTS: We selected 16 original papers, all published in the last 5 years. There was a conflict of interest in 12 of the 16 studies due to sponsorship by the corresponding pharmaceutical companies. According to the validity assessment, ten studies were classified as high quality. Five studies performed a cost-effectiveness analysis comparing ETV with TDF; they concluded that TDF dominates ETV. The other 11 studies compared ETV or TDF with other strategies; all concluded that ETV and TDF are both cost-effective interventions. CONCLUSIONS: This systematic review shows that there is valid evidence suggesting that ETV and TDF are cost-effective interventions for the treatment of patients with chronic hepatitis B in many health systems. In countries where both alternatives are available, it appears that TDF dominates ETV. These results could help decision makers and clinicians to understand economic issues regarding the available drugs for first-line treatment of hepatitis B.
Authors: V G Carande-Kulis; M V Maciosek; P A Briss; S M Teutsch; S Zaza; B I Truman; M L Messonnier; M Pappaioanou; J R Harris; J Fielding Journal: Am J Prev Med Date: 2000-01 Impact factor: 5.043
Authors: Anna Maria N Costa; Gilbert L 'italien; Marcelo Eidi Nita; Evaldo Stanislau A Araujo Journal: Braz J Infect Dis Date: 2008-10 Impact factor: 1.949
Authors: Berlian I Idris; Max Brosa; Jan H Richardus; Rafael Esteban; Solko W Schalm; Maria Buti Journal: Eur J Gastroenterol Hepatol Date: 2008-04 Impact factor: 2.566
Authors: Adrian R Levy; Kris V Kowdley; Uchenna Iloeje; Eskinder Tafesse; Jayanti Mukherjee; Robert Gish; Natalie Bzowej; Andrew H Briggs Journal: Value Health Date: 2007-12-17 Impact factor: 5.725
Authors: Alberto Ferrarese; Alberto Zanetto; Martina Gambato; Ilaria Bortoluzzi; Elena Nadal; Giacomo Germani; Marco Senzolo; Patrizia Burra; Francesco Paolo Russo Journal: World J Gastroenterol Date: 2016-01-28 Impact factor: 5.742
Authors: Giorgio L Colombo; Daria Bettoni; Sergio Di Matteo; Camilla Grumi; Cinzia Molon; Daniela Spinelli; Gaetano Mauro; Alessia Tarozzo; Giacomo M Bruno Journal: Vasc Health Risk Manag Date: 2014-09-10