Antenatal lamivudine to reduce perinatal hepatitis B transmission: a cost-effectiveness analysis

作者：Nayeri Unzila A^*; Werner Erika F; Han Christina S; Pettker Christian M; Funai Edmund F; Thung Stephen F

来源：American Journal of Obstetrics and Gynecology, 2012, 207(3): 231.e1.

DOI：10.1016/j.ajog.2012.06.001

• hepatitis B
• lamivudine
• perinatal transmission
• pregnancy

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.
STUDY DESIGN: 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.

• 出版日期2012-9