Background　Evidence　supports　the　long-term　efficacy　of　Nucleos(t)ide　Analogs　(NAs)　therapy　in　improving　chronic　hepatitis　B　(CHB)　prognosis.　However,　determining　the　most　cost-effective　first-line　NAs　remains　unclear.　China＇s　implementation　of　the　New　Volume-Based　Procurement　Policy　(NVBP　Policy)　in　2019　led　to　substantial　price　reductions　for　entecavir　(ETV),　tenofovir　disoproxil　fumarate　(TDF),　and　tenofovir　alafenamide　(TAF).　This　study　assesses　the　cost-effectiveness　of　ETV,　TDF,　and　TAF,　both　with　and　without　NVBP,　for　CHB　in　China.Methods　A　state-transition　model,　parameterized　using　data　from　published　literature,　was　utilized　to　compare　treatment　strategies　encompassing　non-NAs　best　support　care　(BSC),　ETV,　TDF,　and　TAF,　with　or　without　NVBP.　A　simulated　lifetime　cohort　was　employed,　measuring　outcomes　such　as　predicted　liver-related　deaths,　costs,　quality-adjusted　life-years　(QALYs),　and　incremental　cost-effectiveness　ratios　(ICERs).Results　In　comparison　to　Non-NAs　BSC,　TAF　yielded　an　additional　2.68　QALYs　per　person,　with　an　ICER　of　7,853.22　USD/QALY.　Subsequently,　TDF　generated　an　additional　2.61　QALYs/person　at　an　ICER　of　7,153.39　USD/QALY,　and　ETV　produced　an　additional　2.01　QALYs/person　with　an　ICER　of　9,366.74　USD/QALY　without　NVBP.　Incorporating　NVBP,　the　ICERs　for　TAF,　TDF,　and　ETV　decreased　to　-745.62　USD/QALY,　-729.33　USD/QALY,　and　-871.11　USD/QALY,　respectively,　compared　to　non-NAs　BSC.　At　willingness-to-pay　(WTP)　thresholds　ranging　from　12,500　USD/QALY　to　37,500　USD/QALY,　TAF　with　NVBP　showed　an　increased　probability　(51.15-52.47%)　of　being　the　optimal　treatment　strategy,　followed　by　TDF　and　ETV　with　NVBP　exhibiting　a　reduced　likelihood　43.09-42.45%　and　6.40-4.48%　in　the　iterations.Conclusions　Our　analysis　suggests　that　TAF　with　NVBP　represents　the　most　cost-effective　long-term　therapy　for　CHB.　Both　TDF　and　ETV,　with　or　without　NVBP,　and　TAF　without　NVBP　were　considered　cost-ineffective.