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Research Article
6 February 2024

Cost–effectiveness of switching from tenofovir disoproxil fumarate to tenofovir alafenamide versus entecavir for chronic hepatitis B patients in Greece

Authors: Emmanouil Sinakos, Nandita Kachru [email protected], Christos Tsoulas, Sushanth Jeyakumar, Nathaniel J Smith, Alon Yehoshua, and Evangelos CholongitasAuthor Info & Affiliations
Volume 13, Number 4
https://doi.org/10.57264/cer-2023-0090
PDFFormats

Abstract

Aim: This study assessed the clinical impact and cost–effectiveness of switching from tenofovir disoproxil fumarate (TDF) to either tenofovir alafenamide (TAF) or entecavir (ETV) in a Greek chronic hepatitis B (CHB) population. Patients & methods: A Markov model from the perspective of a third-party payer in Greece quantified the health and economic benefits of switching from TDF to either TAF or ETV over a lifetime horizon. Results: Over a lifetime, patients who switch from TDF to TAF versus patients who switch from TDF to ETV had an overall lower incidence of compensated cirrhosis (0.4% lower), decompensated cirrhosis (0.04% lower) and hepatocellular carcinoma (0.25% lower). Chronic kidney disease and end-stage renal disease were also lower in patients who switch to TAF; major osteoporotic fractures were similar for both groups. While total costs were higher for switching from TDF to TAF versus TDF to ETV due to the higher cost of TAF, switching from TDF to TAF versus ETV was cost effective with an incremental cost–effectiveness ratio of €17,113 per quality-adjusted life year. Conclusion: Switching from TDF to TAF in patients living with CHB is a cost effective strategy to reduce adverse liver disease outcomes, while improving bone- and renal-related safety outcomes.

Plain language summary

What is this article about?

Chronic hepatitis B (CHB) is a major public health issue. Antiviral treatments are effective at treating CHB and include tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF) and entecavir (ETV); TAF is associated with a lower incidence of bone and renal complications compared with TDF. This study evaluated the benefits and costs of switching from TDF to TAF versus TDF to ETV for the treatment of CHB in a Greek population.

What were the results?

This study found that patients switching from TDF to TAF versus ETV had lower estimated incidence of liver disease outcomes, as well as fewer cases of chronic kidney disease and end-stage renal disease; the number of cases of major osteoporotic fractures was similar for patients switching to TAF and ETV.

What do the results of the study mean?

Considering these clinical benefits, while total costs for TAF were higher, it was still considered good value for money.

Supplementary Material

File (supplementary materials.docx)

References

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