Cost-effectiveness analysis of entecavir and lamivudine in treatment of early stage acute-on-chronic liver failure

Abstract

Objective To evaluate the cost-effectiveness of entecavir and lamivudine in treatment of early stage acute on chronic liver failure (ACLF), and analyze the predictive factors. Methods Forty nine patients with early ACLF were enrolled. Of which, 28 patients were treated with entecavir, and 21 patients were treated with lamivudine. Mortality, length of hospital stay, cost, liver function, coagulation function, and model for end-stage liver disease (MELD) score were compared between two groups. Pharmacoeconomic evaluation was taken using cost-effectiveness analysis and cost minimization analysis. Results Mortality, length of hospital stay and cost had no significant difference between two groups. Ratio of cost-effectiveness in lamivudine group was higher than that in entecavir group. Cox analysis showed that primary peritonitis and MELD score at the end of the second week were the main predictive factors. Conclusions Entecavir cannot improve the survival rate of early stage ACLF compared to lamivudine, but may provide economic benefit to patients with early stage ALCF. Key words: Economics, pharmaceutical; Guanine/TU; Lamivudine/TU; Liver failure, acute/DT; Costs and cost analysis; Cost-benefit analysis