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UCLA study assesses cost-effectiveness of Hepatitis B drugs

Center for the Study of Digestive Healthcare Quality and Outcomes and assistant professor of medicine, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System. "The combined treatment strategy of lamivudine and adefovir is also a very viable option. This is part of a trend that we're seeing in other areas of medicine as well ?to use "hybrid" treatments that reserve expensive yet effective drugs for specific patients who have shown no success with other treatments."

Spiegel notes that the general cost-effectiveness standard accepted by society and many insurers for treating a chronic condition like hepatitis B is roughly $50,000 or less per quality-adjusted life-year gained, which is a standard measure used in assessing the outcome of health care procedures or services.

According to Kanwal, the study showed that only two strategies fell well within this accepted standard: Interferon cost an incremental $6,337 to gain an additional quality-adjusted life-year, compared to receiving no treatment at all. Compared with interferon, the hybrid strategy of lamivudine and adefovir cost an incremental $8,446 per quality-adjusted life-year.

In comparison, treatment with adefovir alone cost over $90,000 for each quality-adjusted life-year gained for patients with the e-antigen negative hepatitis B and would not be considered cost-effective according to researchers.

The comprehensive economic model adjusted for various patient scenarios including viral resistance, development of cirrhosis and other factors affecting treatment. Health costs included physician visits, diagnostic tests and complications of chronic liver disease.

Investigators based the model on average 40-year old patients with the most common type of chronic hepatitis B -- with elevated liver enzymes but no liver cirrhosis. Investigators also took into consideration the two types of hepatitis B -- either e- antigen positive or e-antigen negative
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Source:University of California - Los Angeles


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