Sullivan S.D.Veenstra D.L.PEI-JER CHENChang T.-T.Chuang W.-L.Tsai C.Patel K.2021-07-032021-07-0320070815-9319https://www.scopus.com/inward/record.uri?eid=2-s2.0-84984563844&doi=10.1111%2fj.1440-1746.2006.04539.x&partnerID=40&md5=7525f2f3960e56b1d999d1cf2de2d27dhttps://scholars.lib.ntu.edu.tw/handle/123456789/568649Background: Peginterferon alfa-2a (40KD), a new treatment option for patients with chronic hepatitis B (CHB), offers improved efficacy with a defined treatment duration compared with lamivudine, but at a higher cost. We undertook an economic evaluation of peginterferon alfa-2a from the perspective of the Taiwan Bureau of National Health Insurance to assess the clinical outcomes and costs of 48 weeks of peginterferon alfa-2a for the treatment of patients with hepatitis B e antigen (HBeAg)-positive CHB, compared to lamivudine treatment for 48 weeks. Methods: We performed a cost-effectiveness analysis using a state-transition Markov model simulating the natural history of HBeAg-positive CHB. Efficacy data were obtained from a randomized clinical trial of 820 patients (87% were Asian) comparing peginterferon alfa-2a to lamivudine. We modeled a hypothetical cohort of 32-year-old patients with HBeAg-positive CHB. Life expectancy, quality-adjusted life expectancy, lifetime costs ($NTD) and incremental cost-effectiveness ratios (ICER) were estimated. One-way sensitivity analyses were performed on all parameters in the model to evaluate uncertainty. Results: Treatment with peginterferon alfa-2a compared to lamivudine resulted in higher total costs, but longer quality-adjusted life expectancy, yielding an ICER of $NTD 381 000 ($US 12 000) per quality-adjusted life year (QALY) gained. Although there is uncertainty associated with the prognosis of HBeAg-positive CHB, the ICER did not exceed $NTD 485 000 ($US 15 000) per QALY gained despite variation in the parameters used in the analysis. Conclusions: Our analysis suggests that 48-week treatment with peginterferon alfa-2a compared to 48-week treatment with lamivudine in HBeAg-positive patients offers life expectancy and quality of life benefits at a favorable cost-effectiveness ratio. ? 2006 The Authors.Cost-effectiveness; Lamivudine; Peginterferon alfa-2a; Viral hepatitis[SDGs]SDG3hepatitis B(e) antigen; lamivudine; peginterferon alpha2a; article; Asian; cohort analysis; cost effectiveness analysis; drug cost; drug efficacy; health insurance; hepatitis B; life expectancy; priority journal; probability; prognosis; quality adjusted life year; quality of life; sensitivity analysis; simulation; Taiwan; treatment duration; treatment outcomejournal article10.1111/j.1440-1746.2006.04539.x2-s2.0-84984563844