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Cost‐effectiveness analysis of antiviral therapy in patients with advanced hepatitis B virus‐related hepatocellular carcinoma treated with sorafenib
Author(s) -
Zhang Pengfei,
Yang Yu,
Wen Feng,
Wheeler John,
Fu Ping,
Li Qiu
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13425
Subject(s) - medicine , sorafenib , hepatocellular carcinoma , hepatitis b virus , antiviral therapy , hepatitis b , cost effectiveness , oncology , cirrhosis , cost effectiveness analysis , hepatitis c , quality adjusted life year , hepatitis c virus , combination therapy , gastroenterology , immunology , chronic hepatitis , virus , risk analysis (engineering)
Background and Aim Antiviral therapy has been demonstrated to significantly improve the survival in patients with advanced hepatitis B virus (HBV)‐related hepatocellular carcinoma (HCC). The aim of the study was to investigate the cost‐effectiveness of antiviral therapy in patients with advanced HBV‐related HCC treated with sorafenib. Methods To conduct the analysis, a Markov model comprising three health states (progression‐free survival, progressive disease, and death) was created. The efficacy data were derived from medical records. Cost data were collected based on the Chinese national drug prices. Utility data came from the previously published studies. One‐way sensitivity analyses as well as probabilistic sensitivity analyses were performed to explore model uncertainties. Results In the base‐case analysis, addition of antiviral therapy to sorafenib generated an effectiveness of 0.68 quality‐adjusted life years (QALYs) at a cost of $25 026.04, while sorafenib monotherapy gained an effectiveness of 0.42 QALYs at a cost of $20 249.64. The incremental cost‐effectiveness ratio (ICER) was $18 370.77/QALY for antiviral therapy group versus non‐antiviral therapy group. On the other hand, the ICER between the two groups in patients with high or low HBV‐DNA load, with or without cirrhosis, normal or elevated alanine aminotransferase/aspartate aminotransferase were $16 613.97/QALY, $19 774.16/QALY, $14 587.66/QALY, $19 873.84/QALY, $17 947.07/QALY, and $18 785.58/QALY, respectively. Conclusions Based on the cost‐effectiveness threshold ($20 301.00/QALY in China), addition of antiviral therapy to sorafenib is considered to be a cost‐effective option compared with sorafenib monotherapy in patients with advanced HBV‐related HCC in China from the patient's perspective.