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    De kosteneffectiviteit van antivirale middelen ter behandeling van chronische hepatitis B: een literatuurreview

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    Authors
    Struijs JN
    Wit GA de
    Jager JC
    Series/Report no.
    RIVM rapport 403505006
    Type
    Report
    Language
    nl
    
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    Title
    De kosteneffectiviteit van antivirale middelen ter behandeling van chronische hepatitis B: een literatuurreview
    Translated Title
    The cost effectiveness of antiviral medicines in the treatment of chronic hepatitis B: A review of the literature
    Publiekssamenvatting
    National and international economic evaluations of antiviral medicines in the treatment of chronic hepatitis B are reviewed. Searches in a number of databases followed by reference tracking resulted in 47 publications. However, it appeared that 40 publications did not meet our inclusion criteria, so only seven publications proved relevant. The parameters that were included in the review are the types of antiviral medicine, the type of economic evaluation, the different parameters int he disease model, the time horizon of the study, the costs of the antiviral medicines, the different cost data used in the study, the sensitivity analysis, and the results of the studies. Some studies show treatment with antiviral medicine to be cost-saving, while in other studies show unfavourable cost-effectiveness ratios. These contrasting results are due to differences in parameters and methodology between the studies. The tentative conclusion of the literature review is that if quality of life effects are taken into account, treatment with antiviral medicines seems cost-effective. If the quality of life is nog estimated the cost-effectiveness ratios are less favourable. There is no 'hard' evidence that the treatment of chronic hepatitis B with antiviral medicines is cost-effective. Further research is necessary to assess the cost-effectiveness of treatment of chronic hepatitis B with antiviral medicines.
    Er is een beschrijving gemaakt van nationale en international economische evaluaties van de behandeling met antivirale middelen bij chronische hepatitis B patienten. Onze zoekstrategie leverde in totaal 47 referenties op. Echter, 40 publicaties voldeden niet aan de gformuleerde inclusiecreteria, zodat uiteindelijk 7 publicaties in dit literatuuronderzoek zijn betrokken. De geselecteerde economische evaluatie, de verschillende parameters in het ziektemodel, de gekozen tijdshorizon, de gehanteerde kosten van antivirale middelen, de verschillende kostensoorten, de gehanteerde discontovoet, de sensitiviteitsanalyse en de resultaten en conclusies van eht literatuuronderzoek. De bestudeerde studies gaven geen consistent beeld. Sommige tudies beschreven kostenbesparingen, terwijl andere studies juist ongunstige kosteneffectiviteitsratio's beeschreven. Het verschil in resultaten werden veroorzaakt door de verschillen in gekozen parameterwaarden en verschil in methodiek tussen de studies. De conclusie van dit literatuuronderzoek is dat indien de kwaliteit van leven effecten worden meegenomen de behandeling van antivirale middelen kosteneffectief lijkt. Indien alleen overlevingswinst wordt meegenomen zijn de resultaten van de behandeling met antivirale middelen bij chronische hepatitits B patienten ongunstiger. Er is geen harde wetenschappelijke onderbouwing dat de behandeling met antivirale middelen kosteneffectief is. Verder ondrzoek is nodig om de kosteneffectiviteit van antivirale middelen te kunnen bepalen.
    Publisher
    Rijksinstituut voor Volksgezondheid en Milieu RIVM
    URI
    http://hdl.handle.net/10029/9470
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    RIVM official reports

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