Evidence map›Paper›PMID 34733917›Full record

ArticleAnnals of translational medicine2021

Cost-effectiveness of combination antiviral treatment with extended duration for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B in China.

Runqin Li, Xiao Lin, Jing-Yue Wang, Xiaomo Wang, Junfeng Lu, Yali Liu, Zhenhuan Cao, Shan Ren, Lina Ma, Yi Jin and 4 more

Open access · diamondAbstract read
In one paragraph

Article in Annals of translational medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 4 institutions in 1 country.

Runqin LiThe First Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Xiao LinThe First Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Jing-Yue WangDivision of Hepatology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Xiaomo WangDepartment of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.
Junfeng LuThe First Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Yali LiuThe Third Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Zhenhuan CaoThe First Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Shan RenThe First Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Lina MaThe First Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Yi JinThe First Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Sujun ZhengThe First Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Zhongjie HuThe First Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Li WangDepartment of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.
Xinyue ChenThe First Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Capital Medical University · CNBeijing YouAn Hospital · CNChinese Academy of Medical Sciences & Peking Union Medical College · CNTsinghua University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHepatitis B surface antigen clearance or seroconversion is rarely achieved for patients using nucleoside analogs or pegylated interferon alpha monotherapy approaches. Several recent studies have confirmed the benefit of a combination of these two approaches for selected chronic hepatitis B patients. However, few reports have investigated long-term outcomes or health economic evaluation for hepatitis B surface antigen clearance. The aim of this study was to perform a cost-effectiveness analysis of the long-term use of this combination strategy among selected hepatitis B e antigen-negative patients.

methodsDrawing on experience in China, we used a Markov model to simulate disease progression among a population of hepatitis B e antigen-negative chronic hepatitis B patients with surface antigen levels of ≤1,000 IU/mL through a discrete series of health states. We compared nucleoside analog monotherapy to the combination strategy over a prolonged period. We measured lifetime costs, quality-adjusted life-years and incremental cost-effectiveness ratios.

resultsThe combination therapy produced 15.8 quality-adjusted life-years, and cost US dollars (USD) 45,032 per patient. The monotherapy gave 13.9 quality-adjusted life-years, and had a cost of USD 52,064. The incremental cost-effectiveness ratio of the monotherapy (USD -3,755 per quality-adjusted life-year) did not obtain extended dominance over combination therapy. The most cost-effective option was combination therapy among patients with hepatitis B surface antigen levels of ≤10 IU/mL, which had the lowest calculated cost of USD 35,318 and most quality-adjusted life-years (16.7).

conclusionsA long-term combination treatment strategy for selected hepatitis B e antigen-negative chronic hepatitis B patients may prolong quality-adjusted life-years compared with nucleoside analog monotherapy. Chronic hepatitis B patients with a hepatitis B surface antigen level of ≤10 IU/mL were the most cost-effective population under this strategy.

Indexed as

chronic hepatitis BCost-effectivenessfunctional curehepatitis B surface antigen loss (HBsAg loss)quality-adjusted life-years (QALYs)

Identifiers

PMID34733917
PMCPMC8506536
OpenAlexW3206162322

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.