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Cost-effectiveness analysis of lamivudine, telbivudine, and entecavir in treatment of chronic hepatitis B with adefovir dipivoxil resistance

Authors Wang G, Liu Y, Qiu P, Zhou S, Xu L, Wen P, Wen J, Xiao X

Received 24 August 2014

Accepted for publication 28 January 2015

Published 2 June 2015 Volume 2015:9 Pages 2839—2846


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 5

Editor who approved publication: Prof. Dr. Wei Duan

Guiliang Wang,1,2 Yan Liu,2 Ping Qiu,1 Shu-Feng Zhou,3,4 Linfang Xu,1 Ping Wen,1 Jianbo Wen,1 Xianzhong Xiao5

1Department of Digestive Internal Medicine, Gannan Medical University Pingxiang Hospital, Pingxiang, People’s Republic of China; 2Department of Digestive Internal Medicine, 307 Hospital of PLA, Beijing, People’s Republic of China; 3Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA; 4Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center and Sino-US Joint Laboratory for Medical Sciences, Guiyang Medical University, Guiyang, People’s Republic of China; 5Laboratory of Shock, Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha, People’s Republic of China

Abstract: The purpose of this study was to analyze the cost-effectiveness of lamivudine (LMV), telbivudine (LdT), and entecavir (ETV) in treatment of chronic hepatitis B with adefovir dipivoxil (ADV) resistance. Two hundred and fifty-two patients were recruited and screened for resistance to ADV and randomly assigned into three groups: LMV + ADV, LdT + ADV, and ETV + ADV. The ratio of biochemical response, virological response, seroconversion of hepatitis Be antigen (HBeAg)/hepatitis Be antibody (HBeAb), viral breakthrough, and the cost and effectiveness of treatments were analyzed. A comparison of the results of the ratio of biochemical response, virological response and seroconversion of HBeAg/HBeAb, showed no statistical difference between the three groups, with the economic cost of LMV + ADV the lowest, LdT + ADV the middle, and ETV + ADV the highest. The side effects of the three plans are all rare and tolerable. LMV + ADV is the optimal rescue strategy, and LdT + ADV the alternative selection in the economically less developed regions, while ETV + ADV was used in the economically developed regions.

Keywords: chronic hepatitis B, adefovir dipivoxil, lamivudine, telbivudine, entecavir, resistance

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