OBJECTIVES: This study evaluated the cost-effectiveness of TAF versus tenofovir disoproxil fumarate (TDF) and entecavir (ETV; mix of branded / generic) for the treatment of chronic hepatitis B (CHB) virus in Taiwan.

METHODS: A patient-level simulation model was used to simulate the health and economic outcomes for adults with CHB from a Taiwan National Health Insurance payer perspective over a lifetime horizon. Clinical data inputs were sourced from trial data (320-0108 and 320-0110), internal analyses, and published literature. Treatment costs were sourced from the National Health Insurance Administration (NHIA). Health state costs and utilities were sourced from NHIA dataset and published literature. Results are based on a simulated cohort of 100,000 patients. Additional scenario analyses considering a 100% treatment naïve (TN; patients with no previous treatment) population and 3-year time horizon were also performed.

RESULTS: TAF resulted in lower liver-related (cirrhosis, decompensation, or liver cancer) and safety events (chronic kidney disease, end-stage renal disease, osteoporotic fractures) compared to TDF and ETV. As compared to TDF and ETV, TAF was associated with improved life-years (LYs; +0.39 and +0.90, respectively), and quality-adjusted life-years (QALYs; +0.42 and +1.11, respectively). Use of TAF resulted in incremental cost-effectiveness ratios (ICERs) of NT$103,794/QALY (€3,321/QALY) and NT$122,152/QALY (€3,909/QALY) vs. TDF and ETV, respectively, and thus was considered cost-effective assuming a willingness-to-pay threshold of NT$925,000 (1 time GDP per capita). TAF remained cost-effective versus TDF (NT$110,875/QALY; €3,548/QALY) and ETV (NT$134,230/QALY; €4,295/QALY) in the 100% TN scenario. In the 3-year horizon scenario, TAF was dominant (less costly and more effective) versus TDF and cost-effective versus ETV (NT$117,683; €3,766/QALY).

CONCLUSIONS: The model found that TAF results in improved liver- and safety-related outcomes in CHB patients vs. TDF and ETV. Furthermore, TAF is a cost-effective treatment for the treatment of adults with CHB compared to TDF and ETV in Taiwan.