From the perspective of health economics, the evaluation of drug-related cost effectiveness and clinical utility is crucial. We conducted a cost–utility analysis of two first-line drugs, tenofovir alafenamide (TAF) and entecavir (ETV), in the treatment of chronic hepatitis B (CHB) patients. We performed inverse probability of treatment weighting (IPTW) to match the independent variables between the two treatment groups. The incremental cost effectiveness ratio (ICER) of the two treatment groups was simulated using a decision tree with the Markov annual-cycle model. A total of 54 patients treated with TAF and 98 with ETV from January 2016 to December 2020 were enrolled. The total medical cost in the TAF group was NT$76,098 less than that in the ETV group, and TAF demonstrated more effectiveness than ETV by 3.19 quality-adjusted life years (QALYs). When the time horizon was set at 30 years, the ICER of the TAF group compared with the ETV group was −NT$23,878 per QALY, suggesting more cost savings for TAF. Additionally, with the application of TAF, over NT$366 million (approximately US$12 million) can be saved annually. TAF demonstrates cheaper medical costs and more favorable clinical QALYs than ETV. To balance health insurance benefits and cost effectiveness, TAF is the optimal treatment for CHB.
从卫生经济学角度出发，评估药物相关的成本效益与临床效用至关重要。本研究对慢性乙型肝炎（CHB）患者一线治疗药物富马酸丙酚替诺福韦（TAF）与恩替卡韦（ETV）进行成本-效用分析。采用逆概率处理加权法（IPTW）对两组治疗方案的独立变量进行匹配，并通过决策树结合马尔可夫年周期模型模拟两治疗组的增量成本效益比（ICER）。研究纳入2016年1月至2020年12月期间接受TAF治疗的54例患者及ETV治疗的98例患者。结果显示：TAF组总医疗成本较ETV组降低76,098新台币，且TAF较ETV多获得3.19质量调整生命年（QALYs）。当时间跨度设定为30年时，TAF组相较于ETV组的ICER为每QALY节省23,878新台币，表明TAF具有更显著的成本节约优势。此外，应用TAF治疗每年可节省超过3.66亿新台币（约合1200万美元）。与ETV相比，TAF展现出更低的医疗成本与更优的临床QALYs收益。为平衡医疗保险效益与成本效果，TAF是慢性乙型肝炎治疗的优选方案。
肿瘤(癌症)患者之家