Pharmacoeconomics of entecavir treatment for chronic hepatitis B

Background: Entecavir is a new antiviral agent for chronic hepatitis B virus (HBV) infection with potent HBV suppression and a low rate of viral resistance. Objective: To review published studies on the pharmacoeconomics of entecavir for treatment of chronic HBV. Methods: A literature search on Medline and Embase over the period of 1998 - 2008 was performed in April 2008 using keywords 'entecavir' and 'cost'. Results/conclusion: Four studies comparing the cost effectiveness of entecavir with lamivudine and/or adefovir for treatment with chronic HBV infection using either decision tree or Markov modeling were reviewed. All four studies showed that entecavir was cost-effective in the treatment of chronic HBV with the incremental cost per QALY (quality-adjusted life-year) gained below the commonly accepted benchmark. The results are mainly due to the lower complication rates and better quality of life of patients using entecavir which can offset the higher acquisition cost of the drug. Patient characteristics, comparing agents and model assumptions were different among the four studies and they should be taken into account when applying the results to real life situations.