Next Article in Journal
Changes in health-related quality of life among patients with coronary artery disease: a 2-year follow-up
Previous Article in Journal
Diagnosis and treatment of conduct disorder related to frontal lobe syndrome in a 16-year-old girl
Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Cost-effectiveness and cost-utility of the treatment of chronic hepatitis B with peginterferon alfa-2a, interferon alfa, and lamivudine in Lithuania

Department of Preventive Medicine, Medical Academy, Lithuanian University of Health Sciences, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2010, 46(12), 835; https://doi.org/10.3390/medicina46120117
Received: 21 January 2009 / Accepted: 7 December 2010 / Published: 12 December 2010
Background. Chronic hepatitis B infection is an important health care problem worldwide. According to the World Health Organization, 10% to 15% of population is infected with hepatitis B virus. Nearly 100 new cases of acute hepatitis B are annually registered in Lithuania, but official statistics covers only 8–25% of all disease incidence. The aim of this study was to evaluate the cost-effectiveness of the treatment of chronic hepatitis B with peginterferon alfa-2a and compare it to treatment with interferon alfa and lamivudine in Lithuania.
Material and methods
. A Markov model was used to evaluate long-term cost-effectiveness of the treatment with peginterferon alfa-2a and to compare it with treatment with interferon alfa and lamivudine. Peginterferon alfa-2a was administered by subcutaneous injections at a dosage of 180 μg every week for 48 weeks; interferon alfa, 6 million IU three times a week for 24 weeks; and lamivudine, 100 mg per day from 48 weeks to 5 years for HBeAg-positive chronic hepatitis B and 100 mg per day up to 5 years in HBeAg-negative chronic hepatitis B.
Results
. Treatment with peginterferon alfa-2a gained 1.179 life years as compared to 0.658 life years gained with treatment with interferon alfa; incremental costs per incremental life-year gained (LYG) were 51 256.92 Lt (14 845.03 €). Treatment with peginterferon alfa-2a gained 0.545 quality-adjusted life-years (QALYs) with incremental costs per incremental QALY of 48 980.08 Lt (14 185.61 €). Treatment with peginterferon alfa-2a had twice higher cost-effectiveness than treatment with interferon alfa: 50 4167.00 Lt (146 016.85 €) vs. 954 020.08 Lt (276 303.31 €), respectively. Costs for a complete response were also twice lower. Treatment with peginterferon alfa-2a gained 0.757 incremental LYG more compared to lamivudine (48-week course). Comparing incremental cost-effectiveness using peginterferon alfa-2a for treatment, incremental costs per incremental LYG were 41 993.67 Lt (12 162.21 €); additionally there was a gain of 0.792 incremental QALYs, while incremental costs for incremental QALY were 40 096.19 Lt (11 612.66 €). Complete response costs were 83 515.98 Lt (24 187.89 €) less compared to lamivudine (48-week course).
Conclusions. Treatment of chronic hepatitis B prolongs patients’ overall survival and qualityadjusted life. Peginterferon alfa-2a was the most effective drug registered in Lithuania for CHB treatment.
Keywords: cost-effectiveness; hepatitis B; interferon alfa; peginterferon alfa-2a; lamivudine; Lithuania cost-effectiveness; hepatitis B; interferon alfa; peginterferon alfa-2a; lamivudine; Lithuania
MDPI and ACS Style

Vanagas, G.; Padaiga, Ž.; Mickevičienė, A. Cost-effectiveness and cost-utility of the treatment of chronic hepatitis B with peginterferon alfa-2a, interferon alfa, and lamivudine in Lithuania. Medicina 2010, 46, 835.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Only visits after 24 November 2015 are recorded.
Back to TopTop