METHODOLOGICAL CHARACTERISTICS AND QUALITY OF MODEL-BASED HEALTH ECONOMIC EVALUATIONS FOR CHRONIC HEPATITIS B
Author(s)
zhihan liu, BS1, sun huayu, BS1, lai yangyang, BS1, Yuyanzi Zhang, BS2, Xiaoyu Ou, BS1, Hongchao Li, MSc, PhD1.
1China Pharmaceutical University, Nanjing, China, 2China pharmaceutical university, Nanjing, China.
1China Pharmaceutical University, Nanjing, China, 2China pharmaceutical university, Nanjing, China.
OBJECTIVES: To systematically review model-based health economic evaluations (HEEs) for chronic hepatitis B (CHB), critically appraise their methodological characteristics and quality, and summarize key model assumptions and input parameters to inform decision-analytic model development and healthcare decision-making.
METHODS: A systematic literature search (CRD420251164371) was performed across nine electronic databases from inception to April 2026. Two reviewers independently screened records against predefined criteria and extracted data using a standardized form. Methodological quality was assessed using the Philips Checklist.
RESULTS: Of 85 included HEEs, most adopted Markov models (80.0%), conducted cost-utility analyses alone (78.8%), and used a lifetime or ≥30-year time horizon (77.2%); payer (35.3%) and health system perspectives (30.6%) were common. Most models primarily defined health states according to the natural history of CHB (62.3%), and 33 incorporated health states related to functional cure. Model assumptions commonly accounted for the development of antiviral drug resistance and rescue therapy following resistance (67.0%); 21 studies considered therapy discontinuation following HBeAg seroconversion or HBsAg seroclearance, whereas adherence was not modelled separately in most studies (87.1%). Health state utility values (HSUVs) used in the included HEEs were obtained from the literature, and 46 studies used values elicited in original studies. After tracing these cited original studies, HSUVs estimates ranged from 0.52 to 1.00 for CHB, 0.57 to 1.00 for compensated cirrhosis, 0.26 to 0.85 for decompensated cirrhosis, 0.40 to 0.85 for liver transplantation, and 0.31 to 0.85 for hepatocellular carcinoma. Philips Checklist ratings showed 11 to 54 satisfied checklist items across studies, with limited reporting on model input selection, data quality assessment, and model validation.
CONCLUSIONS: Substantial methodological heterogeneity was observed across CHB model-based HEEs, particularly in model structure, key assumptions, and parameter selection. Our findings support the development of a standardized model to improve the comparability, transparency, and policy relevance of future CHB cost-effectiveness analyses.
METHODS: A systematic literature search (CRD420251164371) was performed across nine electronic databases from inception to April 2026. Two reviewers independently screened records against predefined criteria and extracted data using a standardized form. Methodological quality was assessed using the Philips Checklist.
RESULTS: Of 85 included HEEs, most adopted Markov models (80.0%), conducted cost-utility analyses alone (78.8%), and used a lifetime or ≥30-year time horizon (77.2%); payer (35.3%) and health system perspectives (30.6%) were common. Most models primarily defined health states according to the natural history of CHB (62.3%), and 33 incorporated health states related to functional cure. Model assumptions commonly accounted for the development of antiviral drug resistance and rescue therapy following resistance (67.0%); 21 studies considered therapy discontinuation following HBeAg seroconversion or HBsAg seroclearance, whereas adherence was not modelled separately in most studies (87.1%). Health state utility values (HSUVs) used in the included HEEs were obtained from the literature, and 46 studies used values elicited in original studies. After tracing these cited original studies, HSUVs estimates ranged from 0.52 to 1.00 for CHB, 0.57 to 1.00 for compensated cirrhosis, 0.26 to 0.85 for decompensated cirrhosis, 0.40 to 0.85 for liver transplantation, and 0.31 to 0.85 for hepatocellular carcinoma. Philips Checklist ratings showed 11 to 54 satisfied checklist items across studies, with limited reporting on model input selection, data quality assessment, and model validation.
CONCLUSIONS: Substantial methodological heterogeneity was observed across CHB model-based HEEs, particularly in model structure, key assumptions, and parameter selection. Our findings support the development of a standardized model to improve the comparability, transparency, and policy relevance of future CHB cost-effectiveness analyses.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
SA92
Topic
Economic Evaluation, Methodological & Statistical Research, Study Approaches
Topic Subcategory
Decision Modeling & Simulation, Literature Review & Synthesis
Disease
Infectious Disease (non-vaccine)