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The Cost-Effectiveness of Tenofovir Alafenamide for Chronic Hepatitis B Virus in Taiwan

Elise Chia-Hui Tan1, Alon Yehoshua2, Sushanth Jeyakumar3

  • 1Department of Health Service Administration, China Medical University, Taichung, Taiwan.

MDM Policy & Practice
|March 31, 2025
PubMed

Insights

Tenofovir alafenamide (TAF) offers better health outcomes for chronic hepatitis B (CHB) patients compared to tenofovir disoproxil fumarate (TDF) and entecavir (ETV). This antiviral medication is a cost-effective choice for CHB management in Taiwan.

Area of Science:

  • Hepatology
  • Pharmacoeconomics
  • Virology

Background:

  • Chronic hepatitis B (CHB) is a lifelong condition necessitating long-term treatment, posing significant economic challenges.
  • Therapeutic selection for CHB requires careful consideration due to its chronic nature and economic impact.

Purpose of the Study:

  • To evaluate the cost-effectiveness of tenofovir alafenamide (TAF) against tenofovir disoproxil fumarate (TDF) and entecavir (ETV) for CHB management.
  • To assess these treatments from the perspective of the Taiwan National Health Insurance Administration payer over a lifetime horizon.

Main Methods:

  • An individual patient simulation model was employed to assess treatment impacts on liver-related and safety outcomes in CHB.
  • Data from clinical trials, real-world evidence, and published literature were utilized for clinical parameters, health utilities, and costs.

Main Results:

  • TAF demonstrated fewer liver disease events and reduced bone and renal complications compared to TDF and ETV.
  • TAF achieved higher rates of eAg and sAg seroconversion than TDF and ETV.
  • TAF was more effective and more costly, with incremental cost-effectiveness ratios of USD 3,348/QALY vs. TDF and USD 3,940/QALY vs. ETV.

Conclusions:

  • TAF provides superior health outcomes at acceptable incremental costs compared to TDF and ETV.
  • TAF represents a cost-effective treatment option for managing chronic hepatitis B in Taiwan.

Keywords:
chronic hepatitis Bcost-effectiveness analysistenofovir alafenamidetenofovir disoproxil fumarate

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