Cost-effectiveness of Lamivudine, Telbivudine, Adefovir Dipivoxil and Entecavir on decompensated hepatitis B virus-related cirrhosis.
Cost-effectiveness of Lamivudine, Telbivudine, Adefovir Dipivoxil and Entecavir on decompensated hepatitis B virus-related cirrhosis. Eur Rev Med Pharmacol Sci. 2016 Mar;20(5):866-872 Authors: Wang GL, Liu Y, Qiu P, Zhou SF, Xu LF, Wen P, Wen JB, Xiao XZ Abstract OBJECTIVE: To evaluate the cost-effectiveness of lamivudine (LMV), telbivudine (LdT), adefovir dipivoxil (ADV) and entecavir (ETV) on decompensated hepatitis B virus-related cirrhosis. PATIENTS AND METHODS: 1332 patients with decompensated hepatitis B virus-related cirrhosis were randomly assigned into 5 groups with different clinical treatment including LMV treatment, LdT treatment, ADV treatment, LMV+ADV treatment and ETV treatment. And then the liver function, Child-Pugh scores, sero-conversion of HBeAg/HBeAb, polymerase gene mutations, cost-effectiveness, incremental cost-effectiveness and side effects were investigated and further analyzed. RESULTS: LMV, ADV, LdT, LMV+ADV and ETV were all effective on decreasing Child-Pugh scores and conversing negatively hepatitis B virus (HBV) DNA and HBeAg, whereas LMV+ADV and ETV more effective than LMV, ADV and LdT. HBV DNA polymerase genotypic mutations were rare in the 5 groups. The less mutation rate was found in the LMV+ADV and ETV group than in the LMV, ADV and LdT group. Compared to the cost-effectiveness and incremental cost-effectiveness ratio, ETV was the optimal selection, LMV+ADV was the alternative selection and LMV was the cheapest option. The side effects of the 5 plans were all rare and could be controlled. CONCLUSIONS: LMV, ADV, LdT, LMV+ADV and ETV were all effective on treatment of decompensated hepatitis B virus-related cirrhosis whereas ETV and LMV+ADV were recommended. PMID: 27010143 [PubMed – as supplied by publisher]