Economic Evaluation of Treatment of Chronic Hepatitis B in the Province of Misiones

Abstract

INTRODUCTION: Chronic infection by hepatitis B is a serious health burden worldwide and in Argentina. There are several therapeutic strategies aiming at reducing the viral load. OBJECTIVE: To evaluate the cost-effectiveness of different treatment strategies, both in hepatitis B e antigen (HBeAg)-positive and -negative patients. METHODS: A deterministic decision model was used, which considered the main health outcomes associated with hepatitis B virus from the perspective of social security system of the province of Misiones in a 10-year term. The study collected data about costs of drugs, clinical events and complications. Several one-way sensitivity analyses were performed to evaluate uncertainty. RESULTS: Treatment with Tenofovir monotherapy was associated with lower costs and higher efficacy. This was proved both in HBeAg-positive and -negative patients, since Tenofovir treatment was cost-saving, with a cost lower than one gross domestic product per capita per quality-adjusted life year, being the incremental cost-effectiveness rate strategy dominant in both scenarios. Sensitivity analyses confirmed the values of the baseline scenario and showed that the most influential parameter was Tenofovir cost. CONCLUSIONS: Tenofovir treatment proved to be relatively cost-saving. These models may be useful for the decision-making by public health authorities in the province of Misiones.