IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0139876.html
   My bibliography  Save this article

Cost-Effectiveness and Cost Thresholds of Generic and Brand Drugs in a National Chronic Hepatitis B Treatment Program in China

Author

Listed:
  • Mehlika Toy
  • David W Hutton
  • Samuel K So

Abstract

Chronic liver disease and liver cancer associated with chronic hepatitis B (CHB) are leading causes of death among adults in China. Although newborn hepatitis B immunization has successfully reduced the prevalence of CHB in children, about 100 million Chinese adults remain chronically infected. If left unmanaged, 15–25% will die from liver cancer or liver cirrhosis. Antiviral treatment is not necessary for all patients with CHB, but when it is indicated, good response to treatment would prevent disease progression and reduce disease mortality and morbidity, and costly complications. The aim of this study is to analyze the cost-effectiveness of generic and brand antiviral drugs for CHB treatment in China, and assessing various thresholds at which a highly potent, low resistance antiviral drug would be cost-saving and/or cost-effective to introduce in a national treatment program. We developed a Markov simulation model of disease progression using effectiveness and cost data from the medical literature. We measured life-time costs, quality adjusted life years (QALYs), incremental cost-effectiveness ratios (ICERs), and clinical outcomes. The no treatment strategy incurred the highest health care costs ($12,932-$25,293) per patient, and the worst health outcomes, compared to the antiviral treatment strategies. Monotherapy with either entecavir or tenofovir yielded the most QALYs (14.10–19.02) for both HBeAg-positive and negative patients, with or without cirrhosis. Threshold analysis showed entercavir or tenofovir treatment would be cost saving if the drug price is $32–75 (195–460 RMB) per month, highly cost-effective at $62–110 (379–670 RMB) per month and cost-effective at $63–120 (384–734 RMB) per month. This study can support policy decisions regarding the implementation of a national health program for chronic hepatitis B treatment in China at the population level.

Suggested Citation

  • Mehlika Toy & David W Hutton & Samuel K So, 2015. "Cost-Effectiveness and Cost Thresholds of Generic and Brand Drugs in a National Chronic Hepatitis B Treatment Program in China," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-19, November.
    • Handle: RePEc:plo:pone00:0139876
    DOI: 10.1371/journal.pone.0139876
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0139876
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0139876&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0139876?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Rachael Fleurence & Christopher Hollenbeak, 2007. "Rates and Probabilities in Economic Modelling," PharmacoEconomics, Springer, vol. 25(1), pages 3-6, January.
    2. Weixia Ke & Li Liu & Chi Zhang & Xiaohua Ye & Yanhui Gao & Shudong Zhou & Yi Yang, 2014. "Comparison of Efficacy and Safety of Tenofovir and Entecavir in Chronic Hepatitis B Virus Infection: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-8, June.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Kristen Scheckelhoff & Ayesha Ejaz & Igor V. Erovenko & Jan Rychtář & Dewey Taylor, 2021. "Optimal Voluntary Vaccination of Adults and Adolescents Can Help Eradicate Hepatitis B in China," Games, MDPI, vol. 12(4), pages 1-13, October.
    2. Yi-Jun Liu & Adam Keane & Kate T Simms & Jie-Bin Lew & Ju-Fang Shi & Carolyn Mazariego & Susan Yuill & Jose Jeronimo & You-Lin Qiao & Karen Canfell, 2019. "Development and application of a framework to estimate health care costs in China: The cervical cancer example," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-13, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Keith Tolley & Michael Hutchinson & Xiaojun You & Ping Wang & Bjoern Sperling & Ankush Taneja & Mohammed Kashif Siddiqui & Elizabeth Kinter, 2015. "A Network Meta-Analysis of Efficacy and Evaluation of Safety of Subcutaneous Pegylated Interferon Beta-1a versus Other Injectable Therapies for the Treatment of Relapsing-Remitting Multiple Sclerosis," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-21, June.
    2. Louisa G. Gordon & Elizabeth G. Eakin & Rosalind R. Spence & Christopher Pyke & John Bashford & Christobel Saunders & Sandra C. Hayes, 2020. "Cost-Effectiveness Analysis from a Randomized Controlled Trial of Tailored Exercise Prescription for Women with Breast Cancer with 8-Year Follow-Up," IJERPH, MDPI, vol. 17(22), pages 1-13, November.
    3. Louisa G. Gordon & William Leung & Richard Johns & Bronwen McNoe & Daniel Lindsay & Katharina M. D. Merollini & Thomas M. Elliott & Rachel E. Neale & Catherine M. Olsen & Nirmala Pandeya & David C. Wh, 2022. "Estimated Healthcare Costs of Melanoma and Keratinocyte Skin Cancers in Australia and Aotearoa New Zealand in 2021," IJERPH, MDPI, vol. 19(6), pages 1-14, March.
    4. Eun Ju Cho & Jeong-Hoon Lee & Yuri Cho & Yun Bin Lee & Jeong-Ju Yoo & Minjong Lee & Dong Hyeon Lee & Su Jong Yu & Yoon Jun Kim & Jung-Hwan Yoon & Hyo-Suk Lee, 2015. "Comparison of the Efficacy of Entecavir and Tenofovir in Nucleos(T)ide Analogue-Experienced Chronic Hepatitis B Patients," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-10, June.
    5. Mancy, Rebecca & Prosser, Patrick & Rogers, Simon, 2013. "Discrete and continuous time simulations of spatial ecological processes predict different final population sizes and interspecific competition outcomes," Ecological Modelling, Elsevier, vol. 259(C), pages 50-61.
    6. Qiao-Ling Xie & Ying Zhu & Ling-Hong Wu & Lin-Lin Fu & Yan Xiang, 2015. "The Efficacy and Safety of Entecavir and Interferon Combination Therapy for Chronic Hepatitis B Virus Infection: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-19, July.
    7. Marta Soares & Luísa Canto e Castro, 2012. "Continuous Time Simulation and Discretized Models for Cost-Effectiveness Analysis," PharmacoEconomics, Springer, vol. 30(12), pages 1101-1117, December.
    8. Lartey, Stella T. & Si, Lei & Otahal, Petr & de Graaff, Barbara & Boateng, Godfred O. & Biritwum, Richard Berko & Minicuci, Nadia & Kowal, Paul & Magnussen, Costan G. & Palmer, Andrew J., 2020. "Annual transition probabilities of overweight and obesity in older adults: Evidence from World Health Organization Study on global AGEing and adult health," Social Science & Medicine, Elsevier, vol. 247(C).
    9. Mehlika Toy & Fatih Onder & Ramazan Idilman & Gokhan Kabacam & Jan Richardus & Mithat Bozdayi & Meral Akdogan & Zarife Kuloglu & Aydan Kansu & Solko Schalm & Cihan Yurdaydin, 2012. "The cost-effectiveness of treating chronic hepatitis B patients in a median endemic and middle income country," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(5), pages 663-676, October.
    10. Marta O. Soares & Luísa Canto e Castro, 2012. "Continuous Time Simulation and Discretized Models for Cost-Effectiveness Analysis," PharmacoEconomics, Springer, vol. 30(12), pages 1101-1117, December.
    11. Tatia Woodward & Eskinder Tafesse & Peter Quon & Arthur Lazarus, 2010. "Cost Effectiveness of Adjunctive Quetiapine Fumarate Extended-Release Tablets with Mood Stabilizers in the Maintenance Treatment of Bipolar I Disorder," PharmacoEconomics, Springer, vol. 28(9), pages 751-764, September.
    12. Massimo Bilancia & Giuseppe Pasculli & Danilo Di Bona, 2020. "A non-stationary Markov model for economic evaluation of grass pollen allergoid immunotherapy," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-33, May.
    13. Edmund Jones & David Epstein & Leticia García-Mochón, 2017. "A Procedure for Deriving Formulas to Convert Transition Rates to Probabilities for Multistate Markov Models," Medical Decision Making, , vol. 37(7), pages 779-789, October.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0139876. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.