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Updated: May 15, 2026

Real-Time Polymerase Chain Reaction-Based Detection and Quantification of Hepatitis B Virus DNA

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Trends in viral hepatitis cost-effectiveness studies.

Sammy Saab¹, Young Choi, Harman Rahal

¹Department of Medicine, Geffen School of Medicine, University of California, Los Angeles, 200 Medical Plaza, Ste 214, Los Angeles, CA 90095-7302, USA. ssaab@mednet.ucla.edu

The American Journal of Managed Care

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Summary

Most published cost-effectiveness studies on antiviral hepatitis treatments show favorable results, suggesting potential publication bias. Increased scrutiny is needed when using these analyses for healthcare decisions.

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Area of Science:

Pharmacoeconomics
Health Economics
Hepatitis Treatment Research

Background:

Cost-effectiveness analyses (CEA) evaluate treatment strategies comparing effectiveness and cost.
CEA results inform pharmacoeconomic decisions supporting specific treatment pathways.

Purpose of the Study:

To investigate publication bias in cost-effectiveness studies for antiviral hepatitis B and C treatments.
To determine if favorable cost-effectiveness results increase publication likelihood.

Main Methods:

Systematic literature search of original CEA studies (1987-2011) on antiviral hepatitis B/C treatment.
Independent data abstraction by two reviewers and contact with corresponding authors.

Main Results:

71.4% of 77 studies reported cost-effectiveness ratios below $50,000/QALY; 59.7% were below $20,000/QALY.
92.2% of studies reported favorable cost-effectiveness outcomes.
Non-US/European studies showed lower ratios; academic-funded studies were less likely to report ratios below $20,000/QALY.

Conclusions:

A high proportion of published CEA studies on antiviral hepatitis treatments report favorable results.
Potential publication bias exists, possibly due to researchers selecting studies with likely positive outcomes.
Greater awareness and critical evaluation are necessary when interpreting CEA for healthcare decision-making.