Assessing the Benefits and Costs of New Therapies for Hepatitis B Virus Infection
Authors: Douglas K. Owens, Martin Black
Journal: Annals of Internal Medicine (2005)

Editorials17 May 2005Assessing the Benefits and Costs of New Therapies for Hepatitis B Virus InfectionDouglas K. Owens, MD, MS and Martin Black, MDDouglas K. Owens, MD, MSFrom VA Palo Alto Health Care System, Palo Alto, CA 94304, and Temple University School of Medicine, Philadelphia, PA.Search for more papers by this author and Martin Black, MDFrom VA Palo Alto Health Care System, Palo Alto, CA 94304, and Temple University School of Medicine, Philadelphia, PA.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-10-200505170-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In recent years, hepatitis B has taken a backseat to hepatitis C because of the increased prevalence of hepatitis C in the United States and western Europe. However, hepatitis B has reclaimed the attention of gastroenterologists and other health care professionals because of 3 developments: the introduction of polymerase chain reaction (PCR)–based hepatitis B virus (HBV) DNA testing; the improved understanding of the nature of HBV-related disease; and the introduction of potent, orally administered new antiviral agents. In our editorial, we discuss the treatment of HBV, which has evolved rapidly, and then comment on the cost-effectiveness of HBV therapies.The ...References1. Lok AS, McMahon BJ. Chronic hepatitis B: update of recommendations. Hepatology. 2004;39:857-61. [PMID: 14999707] CrossrefMedlineGoogle Scholar2. Keeffe EB, Dieterich DT, Han SH, Jacobson IM, Martin P, Schiff ER, et al. A treatment algorithm for the management of chronic hepatitis B virus infection in the United States. Clin Gastroenterol Hepatol. 2004;2:87-106. [PMID: 15017613] CrossrefMedlineGoogle Scholar3. Kanwal F, Gralnek IM, Martin P, Dulai GS, Farid M, Spiegel BM. Treatment alternatives for chronic hepatitis B virus infection: a cost-effectiveness analysis. Ann Intern Med. 2005;142:821-31. LinkGoogle Scholar4. Zeuzem S. Overview of commercial HBV assays systems. Methods Mol Med. 2004;95:3-13. [PMID: 14982054] MedlineGoogle Scholar5. Locarnini S, McMillan J, Bartholomeusz A. The hepatitis B virus and common mutants. Semin Liver Dis. 2003;23:5-20. [PMID: 12616447] CrossrefMedlineGoogle Scholar6. Dienstag JL, Goldin RD, Heathcote EJ, Hann HW, Woessner M, Stephenson SL, et al. Histological outcome during long-term lamivudine therapy. Gastroenterology. 2003;124:105-17. [PMID: 12512035] CrossrefMedlineGoogle Scholar7. Perrillo R, Hann HW, Mutimer D, Willems B, Leung N, Lee WM, et al. Adefovir dipivoxil added to ongoing lamivudine in chronic hepatitis B with YMDD mutant hepatitis B virus. Gastroenterology. 2004;126:81-90. [PMID: 14699490] CrossrefMedlineGoogle Scholar8. Peters MG, Hann Hw H, Martin P, Heathcote EJ, Buggisch P, Rubin R, et al. Adefovir dipivoxil alone or in combination with lamivudine in patients with lamivudine-resistant chronic hepatitis B. Gastroenterology. 2004;126:91-101. [PMID: 14699491] CrossrefMedlineGoogle Scholar9. Shaw T, Bowden S, Locarnini S. Rescue therapy for drug resistant hepatitis B: another argument for combination chemotherapy? [Editorial]. Gastroenterology. 2004;126:343-7. [PMID: 14699512] CrossrefMedlineGoogle Scholar10. Lau G, Piratvisuth T, Luo KX, et al. Peginterferon alfa-2a (40 KD) (Pegasys®) monotherapy and in combination with lamivudine is more effective than lamivudine monotherapy in HBeAg-positive chronic hepatitis B: results from a large, multinational study [Abstract]. Hepatology. 2004;40:171A. Google Scholar11. Chan HL, Leung NW, Hui AY, Wong VW, Liew CT, Chim AM, et al. A randomized, controlled trial of combination therapy for chronic hepatitis B: comparing pegylated interferon-alpha2b and lamivudine with lamivudine alone. Ann Intern Med. 2005;142:240-50. [PMID: 15710957] LinkGoogle Scholar12. Garber AM, Phelps CE. Economic foundations of cost-effectiveness analysis. J Health Econ. 1997;16:1-31. [PMID: 10167341] CrossrefMedlineGoogle Scholar13. Owens DK. Interpretation of cost-effectiveness analyses [Editorial]. J Gen Intern Med. 1998;13:716-7. [PMID: 9798822] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Douglas K. Owens, MD, MS; Martin Black, MDAffiliations: From VA Palo Alto Health Care System, Palo Alto, CA 94304, and Temple University School of Medicine, Philadelphia, PA.Disclaimer: Dr. Owens is supported by the Department of Veterans Affairs. Views expressed here are those of the authors and do not necessarily reflect those of the Department of Veterans Affairs.Disclosures: Honoraria: M. Black (Gilead).Corresponding Author: Douglas K. Owens, MD, MS, VA Palo Alto Health Care System (111A), 3801 Miranda Avenue, Palo Alto, CA 94304; e-mail, [email protected]edu.Current Author Addresses: Dr. Owens: VA Palo Alto Health Care System (111A), 3801 Miranda Avenue, Palo Alto, CA 94304.Dr. Black: Temple University School of Medicine, Philadelphia, PA. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTreatment Alternatives for Chronic Hepatitis B Virus Infection: A Cost-Effectiveness Analysis Fasiha Kanwal , Ian M. Gralnek , Paul Martin , Gareth S. Dulai , Mary Farid , and Brennan M.R. Spiegel Metrics Cited byCost-Effectiveness of Screening and Vaccinating Asian and Pacific Islander Adults for Hepatitis BDavid W. Hutton, MS, Daniel Tan, MS, Samuel K. So, MD, and Margaret L. Brandeau, PhD 17 May 2005Volume 142, Issue 10Page: 863-864KeywordsAntiviral therapyDNADrug therapyDrugsHealth careHepatitis BInterferonsQuality adjusted life yearsSalvage antiretroviral therapyTreatment guidelines ePublished: 17 May 2005 Issue Published: 17 May 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...