Supplementary materials: Cost–effectiveness of switching from tenofovir disoproxil fumarate to tenofovir alafenamide versus entecavir for chronic hepatitis B patients in Greece

These are peer-reviewed supplementary figures and tables for the article 'Cost–effectiveness of switching from tenofovir disoproxil fumarate to tenofovir alafenamide versus entecavir for chronic hepatitis B patients in Greece' published in the Journal of Comparative Effectiveness Research.Figure S1: Model overviewFigure S2: One-way sensitivity analyses QALYs (left) and costs (right), base caseTable S1: Probability of HBV DNA levels after 48 weeks on treatment (copies/ml)Table S2: Probability of ALT level after 48 weeks on treatment (IU/ml)Table S3: Probability of HbeAg seroconversion after 48 weeks on treatmentTable S4: HCC Risk Hazard Ratio by ALT NormalizationTable S5: Probability of Achieving ALT NormalizationAim: This study assessed the clinical impact and cost–effectiveness of switching from tenofovir disoproxil fumarate (TDF) to either tenofovir alafenamide (TAF) or entecavir (ETV) in a Greek chronic hepatitis B (CHB) population. Patients & methods: A Markov model from the perspective of a third-party payer in Greece quantified the health and economic benefits of switching from TDF to either TAF or ETV over a lifetime horizon. Results: Over a lifetime, patients who switch from TDF to TAF versus patients who switch from TDF to ETV had an overall lower incidence of compensated cirrhosis (0.4% lower), decompensated cirrhosis (0.04% lower) and hepatocellular carcinoma (0.25% lower). Chronic kidney disease and endstage renal disease were also lower in patients who switch to TAF; major osteoporotic fractures were similar for both groups. While total costs were higher for switching from TDF to TAF versus TDF to ETV due to the higher cost of TAF, switching from TDF to TAF versus ETV was cost effective with an incremental cost–effectiveness ratio of €17,113 per quality-adjusted life year. Conclusion: Switching from TDF to TAF in patients living with CHB is a cost effective strategy to reduce adverse liver disease outcomes, while improving bone- and renal-related safety outcomes.</p

Schematic Diagram of HIV Program and Observational Study Design.

<p>The HIV program is divided into 3 distinct activities, HIV testing, Treatment Preparation, and Antiretroviral treatment that includes both community and clinic based facilitators. For entry into the study, subjects must be HIV positive and complete all treatment preparation activities. The study period begins with initiation of ART and evaluates the effects of treatment facilitators on treatment success.</p

Time to Treatment Failure Categorized by Interventions.

<p>Kaplan Meier plots of time to treatment failure stratified by: A) participation in two or more support group meetings; B) having four or more unannounced pill counts by primary care provider; C) at least one home visit; D) having two or more counseling sessions by a pharmacist.</p

Multivariate Analysis of Risk of Failure.

<p>(Cox Proportional Hazards Model). P>0.05 for interactions.</p

Comparisons of Treatment Success and Failures.

<p>Comparisons of Treatment Success and Failures.</p

Participant Flow and Outcomes.

<p>Participant Flow and Outcomes.</p

Rates of Adherence Categorized by Interventions.

<p>Rates of adherence in treatment successes and failures is shown by each intervention: 1) greater than one home visit; 2) participation in two or more support groups; 3) having four or more unannounced pill counts by primary care provider; 4) having two or more counseling sessions by a pharmacist; 5) completing six or more clinic visits.</p

Time to Treatment Failure by Number of Pill Counts Performed.

<p>Time to treatment failure increased as the number of pill counts increased (none = 220 days, 1-3 = 438 days and = 497 days, P < 0.01).</p