OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of current treatments for chronic hepatitis B (CHB) and hepatitis C (CHC) patients using real-world effectiveness data obtained from a pilot hepatitis management program in Taiwan. METHODS: A CHB and a CHC decision analytic model were constructed to simulate lifetime disease progression and to estimate long-term cost-effectiveness of different treatment strategies. The evaluated treatment strategies were lamivudine for HBeAg-positive CHB patients and pegylated interferon plus ribavirin for CHC patients. The strategies were compared to standard care strategy. A time frame of 50 years was chosen for a hypothetical cohort of 30-year-old HBeAg-positive CHB patients and a 40-year timeframe was chosen for a cohort of 40-year-old CHC patients. A comprehensive literature review was performed to obtain the estimates for model parameters. Therapeutic effectiveness was estimated from the 2006 database of a pilot hepatitis management program within the National Health Insurance. BNHI’s perspective and 3% discount rate for both costs and effectiveness were adopted in the analysis. Local data was used whenever possible. One-way sensitivity analysis and probabilistic sensitivity analysis were conducted. RESULTS: For CHB patients treated with lamivudine, the discounted gain in effectiveness comparing with non-antiviral treatment group was 0.19 quality-adjusted life years (QALYs). The incremental cost-effectiveness ratio (ICER) was NT$ 225,800 per QALY (exchange rate: US$=NT$32.5). Spontaneous seroconversion rate and spontaneous relapse rate were the top two influential parameters on ICER. In the CHC model, compared to standard care, patients treated with pegylated interferon plus ribavirin resulted in a 0.94 QALY gain (discounted) and was cost saving. Therefore, the evaluated strategy was considered a dominant alternative. CONCLUSIONS: The two treatment strategies covered by the pilot program were cost effective. Results of this study using real world data further validated the findings in published cost-effectiveness analysis using clinical trial results.