Resumo

VANNESS, David et al. Cost-utility of tenofovir compared with entecavir in first-line treatment of chronic hepatitis B. J Port Gastrenterol. [online]. 2012, vol.19, n.4, pp.170-182. ISSN 0872-8178.

Introduction: Tenofovir and entecavir are the two recommended first-line oral antiviral therapies for treatment of chronic hepatitis B. Goal: To estimate the cost-effectiveness of the two alternatives in adult patients with active chronic hepatitis B. Methods: A Markov model, conditional on HBeAg positivity/negativity, was built on two dimensions: disease stage and therapeutic line. Efficacy data reported in clinical trials was measured in quality adjusted life years. Costs were obtained using the modified Delphi panel method. A lifetime time horizon and a 5% annual discount rate were assumed. Results: Tenofovir, when compared to entecavir as a first-line antiviral oral therapy, results in a 20% decrease in the number of therapy failures. With tenofovir, the rate of new cirrhoses cases, hepatocellular carcinoma and liver transplants, is also lower. Tenofovir when compared to entecavir, results in a lifetime total average discounted (undiscounted) cost saving of 11,865D (23,046D) and a 0.04 increment in quality adjusted life years. As such, tenofovir is a dominant strategy when compared to entecavir. Conclusions: In the analysis and when clinically viable, tenofovir is a more effective and less costly strategy for initial oral antiviral treatment of CHB when compared to entecavir.

Palavras-chave : Economic evaluation; Chronic hepatitis B; Treatment; Tenofovir disoproxilfumarate; Entecavir.

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