Efficacy and Cost-Effectiveness Analyses of Entecavir versus Tenofovir Amibufenamide in Patients with Chronic Hepatitis B.

PURPOSE: To evaluate the efficacy and cost-effectiveness of entecavir (ETV) versus tenofovir amibufenamide (TMF) in patients with chronic hepatitis B.

PATIENTS AND

METHODS

In this retrospective study, patients diagnosed with chronic hepatitis B between January 2022 and June 2024 were screened. Those receiving ETV as first-line therapy were 1:1 propensity score-matched to TMF recipients. The primary endpoint was HBV-DNA negativity conversion at week 48.

RESULTS

Of 50,645 screened patients, 182 met eligibility criteria (TMF, n=91 [48 HBeAg-positive, 43 HBeAg-negative]; ETV, n=91 [36 HBeAg-positive, 55 HBeAg-negative]). HBeAg status was balanced between groups (P = 0.074). At week 48, HBV-DNA negativity was 54.95% for TMF and 76.92% for ETV (P = 0.002; OR 95% CI, 0.193-0.693). Among HBeAg-negative patients, ETV achieved significantly higher negativity at week 24 (P = 0.028) and week 48 (P = 0.041); subgroup findings are exploratory. Treatment costs over 48 weeks were $14060.62 for TMF and $13334.70 for ETV, largely due to national health insurance coverage of ETV. The ICER of TMF versus ETV was -36.28, indicating ETV is more cost-effective. The substantial cost difference is primarily attributable to ETV being covered by national health insurance. Adverse event rates were comparable between the two drugs, indicating similar safety profiles.

CONCLUSION

ETV showed better virologic response and lower drug-related costs than TMF in this single-center retrospective study, especially in HBeAg-negative patients. Further validation in multicenter prospective studies is needed.