Antenatal lamivudine to reduce perinatal hepatitis B transmission: a cost-effectiveness analysis.
Am J Obstet Gynecol
; 207(3): 231.e1-7, 2012 Sep.
Article
em En
| MEDLINE
| ID: mdl-22939730
ABSTRACT
OBJECTIVES:
This study aimed to determine whether administration of lamivudine to pregnant women with chronic hepatitis B in the third trimester is a cost-effective strategy in preventing perinatal transmission. STUDYDESIGN:
We developed a decision analysis model to compare the cost-effectiveness of 2 management strategies for chronic hepatitis B in pregnancy (1) expectant management or (2) lamivudine administration in the third trimester. We assumed that lamivudine reduced perinatal transmission by 62%.RESULTS:
Our Markov model demonstrated that lamivudine administration is the dominant strategy. For every 1000 infected pregnant women treated with lamivudine, $337,000 is saved and 314 quality-adjusted life-years are gained. For every 1000 pregnancies with maternal hepatitis B, lamivudine prevents 21 cases of hepatocellular carcinoma and 5 liver transplants in the offspring. The model remained robust in sensitivity analysis.CONCLUSION:
Antenatal lamivudine administration to pregnant patients with hepatitis B is cost-effective, and frequently cost-saving, under a wide range of circumstances.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transmissão de Doença Infecciosa
/
Inibidores da Transcriptase Reversa
/
Lamivudina
/
Hepatite B Crônica
Tipo de estudo:
Health_economic_evaluation
/
Prognostic_studies
Limite:
Female
/
Humans
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Pregnancy
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article