Table 2.

Cost analysis of treating HBeAg-positive patients up to 5 years using HBeAg seroconversion as an outcome measure

	Cost/dose (USD)a	Cost year 1 (USD)	Cost year 5 (USD)	Year 1 SCb	Year 5 durable SCc	Cost/SC Year 5
No treatment	0	0	0	6	30	0
LMV/ADV	4.30/5.40	1,115	10,500	17	54	19,400
ADV/LMV	5.40	1,932	10,200	12	44	23,300
ETV	7.50	2,408	11,700	21	58	20,400
PEG	280	13,440	13,440	27	55	24,436

Note: Lamivudine had the lowest initial outlay at US$1115/year, but became more expensive than adefovir monotherapy at 5 years due to resistant patients requiring combination therapy. LMV/ADV, ADV/LMV, and ETV had comparable cost per seroconversion. Although entecavir is the most expensive oral antiviral, it is notable that by 5 years 70% of patients on lamivudine would be resistant and would need rescue with adefovir, and similarly 29% in the adefovir group would be adefovir resistant and need rescue with lamivudine, hence contributing to additional costs. LMV = lamivudine, ADV = adefovir, ETV = entecavir, PEG = pegylated interferon, SC = HBeAg seroconversion, USD = United States dollars, ICER = incremental cost-effectiveness ratio

^aEstimated from average retail cost 2007 and converted to USD

^bYear 1 seroconversion rates [31–35]

^cYear 5 durable seroconversion rates. Estimated for entecavir based on projections using 96 weeks data and assumed not worse than lamivudine. Estimated for pegylated-interferon. Durability estimated as 70% for lamivudine, 91% for adefovir, 82% for entecavir and 95% for PEG-interferon