Cost-effectiveness analysis of traditional Chinese medicine combined with antiviral drugs for hepatitis B cirrhosis based on Markov model

Abstract Background Hepatitis B cirrhosis brings a heavy burden to the health care system all over the world, and traditional Chinese medicine had a good effect in the treatment of hepatitis B cirrhosis. To correctly understand the clinical effect of Chinese medicine combined with antiviral drugs in the treatment of hepatitis B cirrhosis, the long-term therapeutic effect of traditional Chinese medicine combined with antiviral drugs in the treatment of hepatitis B cirrhosis was simulated using Markov model analysis.Methods We used four-state Markov modelling with a probabilistic cohort analysis to calculate the cost per quality-adjusted life year (QALY) gained. A one-year cycle length was applied. The best available evidence provided the model with data on the state of hepatitis B cirrhosis, risk of mortality, utility weight, and probability of transition between disease costs. A 3% discount rate was used for costs and QALYs. Cost-effectiveness acceptability curves were presented to assist decision makers.Results The model indicated that the combination of traditional Chinese medicine and antiviral therapy was cost-effective, and the result showed that there was some uncertainty. In the treatment of hepatitis B cirrhosis simulated by Markov model for 20 years, the combination of traditional Chinese medicine and anti-virus drugs increased 1.48 QALYs per patient compared with the use of antiviral drugs alone, and the total cost saved was 45,551.61 yuan. The total cost saving was mainly due to the reduction of number of hospitalizations caused by serious complications.Conclusion The combination of traditional Chinese medicine and antiviral in the treatment of hepatitis B cirrhosis could save the cost of hospitalization and improve the health output, which was a better outcome evaluated by pharmacoeconomics.