Analysis of the cost-effectiveness of antiviral therapies in chronic hepatitis B patients in Korea

Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
The Korean Journal of Hepatology 04/2009; 15(1):25-41. DOI: 10.3350/kjhep.2009.15.1.25
Source: PubMed

ABSTRACT The purpose of this study was to evaluate the cost-effectiveness of 1 year and up to 5 years of antiviral treatment for chronic hepatitis B (CHB).
Two ten-health-state Markov models were developed for CHB patients. The proportion of patients remaining alive in each health state, and healthcare costs and quality-adjusted life years (QALYs) were determined during annual cycles of these Markov models. The total healthcare costs, life years, and QALYs over the 40-year time horizon of the model were calculated. The perspectives of the cost-effectiveness analysis were the Korean healthcare system and the healthcare needs of the CHB patient.
Short-course therapy with alpha-interferon or 1-year treatment with pegylated interferon alpha-2a, lamivudine (LMV), or adefovir (ADV) had limited impact on disease progression. In contrast, either LMV-ADV or ADV-LMV as rescue medication administered for 5 years resulted in a more sustained decrease in the rate of disease progression. The cost-effectiveness threshold in Korea was estimated to be approximately 25,000,000 South Korean won. LMV administered for 1 year is cost-effective in comparison with no treatment for both HBeAg-positive and HBeAg-negative CHB patients, but longer duration antiviral therapies administered for up to 5 years in CHB patients were found to be highly cost-effective by international standards.
Antiviral treatment of CHB with LMV or ADV for up to 5 years using the alternative antiviral agent as rescue medication appears to be a cost-effective strategy for both HBeAg-positive and HBeAg-negative CHB patients in Korea. Economic evaluation of antiviral therapies should be studied further and updated, particularly for newer agents.

  • [Show abstract] [Hide abstract]
    ABSTRACT: In recent years second-order cascading effects in non-centrosymmetric crystals have drawn much attention not only in the context of basic understanding of the nonlinear optical processes but also potential applications in all-optical devices such as optical switches and transistors. Since the amount of phase change due to the second-order cascading is proportional to the square of the effective d-value, organic crystals with large second-order susceptibilities, such as 3-methyl-4-methoxy-4-nitrostilbene (MMONS) are of great interest in this respect. MMONS crystals show one of the largest second-order susceptibilities and the effective d-value was measured to be d<sub>eff </sub>=38 pm/V at 1.064 μm by Maker fringe technique
    Nonlinear Optics '98: Materials, Fundamentals and Applications Topical Meeting; 09/1998
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To estimate the cost-effectiveness of switching patients with poorly controlled type 2 diabetes mellitus from human insulin (HI) to biphasic insulin aspart 30 (BIAsp 30) in South Korea. A published and validated diabetes computer simulation model (the IMS CORE Diabetes Model) was used to evaluate the long-term clinical and economic outcomes associated with switching to BIAsp 30, using treatment effects from the South Korean subgroup of the Physician's Routine Evaluation of Safety and Efficacy of NovoMix 30 Therapy study and cost data collected through primary research. Outcomes included life expectancy, quality-adjusted life expectancy, incidence of complications, direct medical costs, and cost-effectiveness. Analyses were performed from a third-party payer perspective over a 30-year time horizon. Future costs and clinical benefits were discounted at 5% per annum. Extensive sensitivity analyses were performed. Results: Switching patients uncontrolled on HI to BIAsp 30 was projected to increase discounted mean life expectancy by 0.15 +/- 0.18 years per patient (8.62 +/- 0.13 years vs. 8.47 +/- 0.13 years) and improve discounted mean quality-adjusted life expectancy by 0.30 +/- 0.12 quality-adjusted life-years (QALYs) per patient (5.68 +/- 0.09 QALYs vs. 5.38 +/- 0.09 QALYs). Conversion to BIAsp 30 was associated with a mean increase in direct costs of South Korean Won (KRW) 1,777,323 +/- 359,209 over patient lifetimes. BIAsp 30 was associated with an incremental cost-effectiveness ratio of KRW5,916,758 per QALY gained versus HI. Switching patients uncontrolled on HI to BIAsp 30 was projected to improve life expectancy and quality-adjusted life expectancy. This analysis suggests that BIAsp 30 could be a cost-effective treatment option in type 2 diabetes patients poorly controlled on HI in South Korea.
    Value in Health 11/2009; 12 Suppl 3(s3):S55-61. DOI:10.1111/j.1524-4733.2009.00628.x · 2.89 Impact Factor
  • Source
    12/2011; 17(4):258-60. DOI:10.3350/kjhep.2011.17.4.258
Show more


1 Download
Available from