Table 6.
Base case results of various scenarios: costs, quality adjusted life years (QALYs) gained, incremental QALYs, incremental costs and incremental cost-effectiveness ratios (ICERs)
| Treatment | NH* | Lam | Lam + ADV | Lam + TDF | ||||
|---|---|---|---|---|---|---|---|---|
| HBeAg status | + | − | + | − | + | − | + | − |
| CHB (no cirrhosis) | ||||||||
| Cumulative costs (×1,000 TL (€)) | 25.7 (12.8) | 48.2 (23.9) | 31.6 (15.7) | 72.6 (36.1) | 73.4 (36.5) | 168.5 (83.8) | 54.7 (27.2) | 122.5 (60.9) |
| Cumulative QALYs | 14.0 | 9.3 | 14.5 | 9.9 | 17.0 | 13.0 | 17.5 | 13.8 |
| Incremental costs (×1,000 TL (€))a | – | – | 5.8 (2.9) | 24.4 (12.1) | 41.9 (20.8) | 120.3 (59.9) | 23.2 (11.5) | 74.4 (37.0) |
| Incremental QALYsb | – | – | 0.5 | 0.6 | 3.0 | 3.7 | 3.5 | 4.5 |
| ICER (×1,000 TL (€)/QALY) | – | – | 11.2 (5.5) | 38.3 (19.0) | 13.9 (6.9) | 32.1 (16.0) | 6.6 (3.2) | 16.3 (8.1) |
| Cirrhosis | ||||||||
| Cumulative costs (×1,000 TL (€)) | 104.9 (52.2) | 93.9 (46.7) | 128.1 (63.7) | 117.2 (20.1) | 205.5 (102.2) | 180.0 (89.6) | 160.6 (79.9) | 154.6 (76.9) |
| Cumulative QALYs | 6.2 | 6.2 | 8.1 | 7.4 | 13.2 | 12.9 | 13.7 | 13.5 |
| Incremental costs (×1,000 TL (€))a | – | – | 23.3 (11.6) | 23.2 (11.6) | 100.7 (50.0) | 86.1 (42.8) | 55.8 (27.5) | 60.6 (30.1) |
| Incremental QALYsb | – | – | 1.9 | 1.2 | 7 | 6.7 | 7.5 | 7.3 |
| ICER (×1,000 TL (€)/QALY) | – | – | 12.5 (6.2) | 20.1 (10.0) | 14.5 (7.2) | 12.9 (6.4) | 7.5 (3.7) | 8.3 (4.1) |
| Treatment | Peg INF + TDF | ETV | TDF | Roadmap | |||
|---|---|---|---|---|---|---|---|
| HBeAg status | + | − | + | − | + | − | − |
| CHB (no cirrhosis) | |||||||
| Cumulative costs (×1,000 TL (€)) | 58.7 (29.2) | 161.0 (80.1) | 46.0 (22.9) | 218.0 (108.5) | 34.8 (17.3) | 165.9 (82.5) | 94.8 (47.1) |
| Cumulative QALYs | 17.5 | 14.9 | 18.8 | 16.6 | 19.0 | 16.8 | 12.2 |
| Incremental costs (×1,000 TL (€))a | 27.1 (13.5) | 112.9 (56.2) | 14.4 (7.2) | 169.9 (84.5) | 3.2 (1.6) | 117.7 (58.5) | 46.6 (23.2) |
| Incremental QALYsb | 3.5 | 5.6 | 4.8 | 7.3 | 5.0 | 7.6 | 2.9 |
| ICER (×1,000 TL (€)/QALY) | 7.8 (3.9) | 20.0 (9.9) | 3.0 (1.5) | 23.2 (11.6) | 0.6 (0.3) | 15.6 (7.8) | 15.6 (7.9) |
| Cirrhosis | |||||||
| Cumulative costs (×1,000 TL (€)) | 162.9 (81.0) | 168.2 (83.7) | 218.5 (108.7) | 220.8 (109.8) | 163.5 (81.3) | 163.1 (81.2) | – |
| Cumulative QALYs | 14.6 | 14.3 | 16.9 | 16.5 | 17.2 | 16.7 | – |
| Incremental costs (×1,000 TL (€))a | 58.1 (28.9) | 74.2 (36.9) | 113.6 (56.5) | 126.8 (63.1) | 58.6 (29.2) | 69.1 (34.4) | – |
| Incremental QALYsb | 8.4 | 8.0 | 10.7 | 10.3 | 11.0 | 10.5 | – |
| ICER (×1,000 TL (€)/QALY) | 6.9 (3.4) | 9.2 (4.6) | 10.7 (5.3) | 12.3 (6.1) | 5.3 (2.6) | 6.6 (3.3) | – |
NH natural history, Lam lamivudine, Lam + ADV adefovir salvage therapy, Peg_IFN + TDF pegylated interferon followed by tenofovir, ETV entecavir, TDF tenofovir
* “NH (no treatment)” was the baseline strategy compared with other treatment strategies
aDifference in costs over NH
bDifference in healthy years over NH