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• W1993687648 abstract "O tenofovir e o entecavir são os antivíricos orais recomendados no tratamento de primeira linha da hepatite B crónica. Estimar o custo-utilidade comparativo do tenofovir e do entecavir como tratamento oral inicial em adultos com hepatite B crónica. Foi construído um modelo de Markov com 2 dimensões: estádio da doença e opção terapêutica, consoante a positividade/negatividade do AgHBe. Os dados de eficácia reportados nos ensaios clínicos foram medidos em termos de anos de vida ajustados pela qualidade. Os custos foram obtidos através do método de painel de Delphi modificado. Foi assumido como horizonte temporal a esperança média de vida e uma taxa de actualização de 5% ao ano. Estima-se que o tratamento inicial com tenofovir, quando comparado com entecavir, resulte numa redução de 20% nas falências terapêuticas em primeira linha. A taxa de incidência de cirrose, de carcinoma hepatocelular e de transplantes hepáticos é inferior na opção tenofovir. A opção tenofovir resulta numa poupança de custos médios totais atualizados (não atualizados) ao longo da vida de 11 865 € (23 046 €) e num incremento de 0,04 anos de vida ajustados pela qualidade. De acordo com a análise, quando clinicamente viável, o tratamento inicial com tenofovir quando comparado com entecavir é uma estratégia dominante, pois permite maiores ganhos em saúde por um custo inferior. Tenofovir and entecavir are the two recommended first-line oral antiviral therapies for treatment of chronic hepatitis B. To estimate the cost-effectiveness of the two alternatives in adult patients with active chronic hepatitis B. A Markov model, conditional on HBeAg positivity/negativity, was built on two dimensions: disease stage and therapeutic line. Efficacy data reported in clinical trials was measured in quality adjusted life years. Costs were obtained using the modified Delphi panel method. A lifetime time horizon and a 5% annual discount rate were assumed. Tenofovir, when compared to entecavir as a first-line antiviral oral therapy, results in a 20% decrease in the number of therapy failures. With tenofovir, the rate of new cirrhoses cases, hepatocellular carcinoma and liver transplants, is also lower. Tenofovir when compared to entecavir, results in a lifetime total average discounted (undiscounted) cost saving of 11,865€ (23,046€) and a 0.04 increment in quality adjusted life years. As such, tenofovir is a dominant strategy when compared to entecavir. In the analysis and when clinically viable, tenofovir is a more effective and less costly strategy for initial oral antiviral treatment of CHB when compared to entecavir." @default.
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• W1993687648 date "2012-07-01" @default.
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• W1993687648 title "Custo-utilidade do tenofovir comparado com entecavir no tratamento em primeira linha da hepatite B crónica" @default.
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• W1993687648 doi "https://doi.org/10.1016/j.jpg.2012.04.008" @default.
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