Cost-effectiveness analysis of S-ademetionine compared with ursodeoxycholic acid for the treatment of Intrahepatic Cholestasis in China

Abstract Chronic liver disease is a costly health problem that is increasing in prevalence in China. Intrahepatic cholestasis (IHC), such as alcoholic liver disease and non-alcoholic fatty liver disease, are the leading causes of chronic liver disease. In China, the recommended treatments for IHC are S-Adenosylmethionine (SAMe) and ursodeoxycholic acid (UDCA). Despite its use as a supplement in liver disease in China and worldwide, no studies assessing the cost-effectiveness or cost-utility of SAMe compared with UDCA in IHC have been identified in the literature. The aim of this study is to assess the cost-effectiveness of SAMe compared with UDCA in a Chinese clinical setting. The modelled economic evaluation was undertaken using two paralleled decision-analytic Markov models: SAMe compared with placebo and UDCA compared with placebo. The results show that SAMe yielded an additional 3.49 QALYs at CNY263,417 per 100 patients, resulting in an ICER of CNY75,423 compared to placebo. UDCA resulted in a gain of 0.87 QALYs at an additional cost of CNY358,197 per 100 patients and an ICER=CNY410,361 compared to placebo. SAMe is dominating UDCA with an ICER of -CNY36,175, and it is estimated to be a cost-effective option for improving health outcomes and saving costs in China.