Supplementary materials: Cost–effectiveness of switching from tenofovir disoproxil fumarate to tenofovir alafenamide versus entecavir for chronic hepatitis B patients in Greece

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posted on 2024-02-09, 16:00 authored by Emmanouil Sinakos, Nandita Kachru, Christos Tsoulas, Sushanth Jeyakumar, Nathaniel Smith, Alon Yehoshua, Evangelos Cholongitas

These are peer-reviewed supplementary figures and tables for the article 'Cost–effectiveness of switching from tenofovir disoproxil fumarate to tenofovir alafenamide versus entecavir for chronic hepatitis B patients in Greece' published in the Journal of Comparative Effectiveness Research.

Figure S1: Model overview
Figure S2: One-way sensitivity analyses QALYs (left) and costs (right), base case
Table S1: Probability of HBV DNA levels after 48 weeks on treatment (copies/ml)
Table S2: Probability of ALT level after 48 weeks on treatment (IU/ml)
Table S3: Probability of HbeAg seroconversion after 48 weeks on treatment
Table S4: HCC Risk Hazard Ratio by ALT Normalization
Table S5: Probability of Achieving ALT Normalization

Aim: This study assessed the clinical impact and cost–effectiveness of switching from tenofovir disoproxil fumarate (TDF) to either tenofovir alafenamide (TAF) or entecavir (ETV) in a Greek chronic hepatitis B (CHB) population. Patients & methods: A Markov model from the perspective of a third-party payer in Greece quantified the health and economic benefits of switching from TDF to either TAF or ETV over a lifetime horizon. Results: Over a lifetime, patients who switch from TDF to TAF versus patients who switch from TDF to ETV had an overall lower incidence of compensated cirrhosis (0.4% lower), decompensated cirrhosis (0.04% lower) and hepatocellular carcinoma (0.25% lower). Chronic kidney disease and endstage renal disease were also lower in patients who switch to TAF; major osteoporotic fractures were similar for both groups. While total costs were higher for switching from TDF to TAF versus TDF to ETV due to the higher cost of TAF, switching from TDF to TAF versus ETV was cost effective with an incremental cost–effectiveness ratio of €17,113 per quality-adjusted life year. Conclusion: Switching from TDF to TAF in patients living with CHB is a cost effective strategy to reduce adverse liver disease outcomes, while improving bone- and renal-related safety outcomes.