Cost-effectiveness of Managing HBV Reactivation in Patients with Resolved HBV Infection Treated with Anti-CD20 Antibody for B-cell Non-Hodgkin Lymphoma

Overview

Journal Sci Rep

Specialty Science

Date 2022 May 5

PMID 35513395

Authors

Misuzu Fujita

Shigeru Kusumoto

Itsuko Ishii

Tadashi Iwata

Takehiko Fujisawa

Masaya Sugiyama

Akira Hata

Masashi Mizokami

Affiliations

Soon will be listed here.

Abstract

There is no universal recommendation for managing the reactivation of HBV in patients with resolved HBV infection treated with anti-CD20 monoclonal antibodies for B-cell non-Hodgkin lymphoma. This study compared the cost-effectiveness of two commonly used strategies: prophylactic anti-HBV nucleos(t)ide analog therapy (Pro NAT), and HBV DNA monitoring followed by on-demand antiviral therapy (HBV DNA monitoring). Using a decision tree model, the incremental cost-effectiveness ratio (ICER) expressed as cost per quality-adjusted life-year (QALY) gained was calculated. The threshold for cost-effectiveness was set at 5,000,000 JPY, equivalent to 45,662 USD. In a base-case analysis, HBV DNA monitoring was found to be more cost-effective based on the calculation of ICER as 132,048 USD per QALY, a value that far exceeds 45,662 USD. The same results were consistently obtained by a one-way deterministic sensitivity analysis, even after changing each parameter value within the predetermined range. A probabilistic sensitivity analysis with 10,000 simulations also revealed that HBV DNA monitoring is more cost-effective than Pro NAT in 96.8% of cases. Therefore, this study suggests that HBV DNA monitoring is an appropriate managing measure in Japan from a cost-effectiveness perspective.

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