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Open Access 03-02-2025 | Hepatitis B | Original Article

Assessing pricing and affordability of HBV treatment in Asia–Pacific region: a barrier to elimination

Authors: Jing Chen, Jidong Jia, Hui Zhuang, Wenhong Zhang, Jin Mo Yang, Tawesak Tanwandee, Diana Payawal, Saeed Hamid, Shiv Kumar Sarin, Masao Omata, Guiqiang Wang, George Lau, Apasl Viral Elimination Task Force

Published in: Hepatology International

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Abstract

Background

The Asia–Pacific (AP) region carries a substantial burden of HBV. Affordable HBV treatment is crucial to attain WHO’s elimination goal. This study assesses the pricing and affordability of HBV treatment in AP.

Methods

A survey conducted among APASL members from 2 Aug to 30 Oct, 2023, gathered data on antiviral HBV drugs, treatment costs covering stages of chronic hepatitis B (CHB), compensated cirrhosis (CC), hepatocellular carcinoma (HCC), liver transplant, and monitoring expenses. Drug costs for TDF and ETV were compared to international reference price (TDF: $30, ETV: $36 per person per year), generating a median price ratio (MPR) where MPR < 1 indicated an acceptable local price. Affordability was evaluated by comparing yearly CHB treatment cost to yearly minimum wage in each country/area, all converted to 2023 US$.

Results

ETV costs ranged from $42 per person per year in Pakistan to $2640 in Malaysia, while TDF costs varied from $12 in mainland China to $2446 in Hong Kong. Almost all MPR exceeded 1. Affordability of HBV treatment varied, with CHB patients in Australia paying 1.4% of minimum yearly wage to get 1 year CHB treatment, in contrast to Myanmar’s 78.6%. Affordability disparities were also evident for patients with CC, HCC, and liver-transplant needs, though monitoring costs were generally affordable.

Conclusions

Despite patent expiration and availability of low-cost generics for TDF and ETV, HBV medication costs in Asia–Pacific region remain high. CHB treatment is generally unaffordable for patients, posing a significant barrier to HBV elimination in this endemic region.
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Metadata
Title
Assessing pricing and affordability of HBV treatment in Asia–Pacific region: a barrier to elimination
Authors
Jing Chen
Jidong Jia
Hui Zhuang
Wenhong Zhang
Jin Mo Yang
Tawesak Tanwandee
Diana Payawal
Saeed Hamid
Shiv Kumar Sarin
Masao Omata
Guiqiang Wang
George Lau
Apasl Viral Elimination Task Force
Publication date
03-02-2025
Publisher
Springer India
Published in
Hepatology International
Print ISSN: 1936-0533
Electronic ISSN: 1936-0541
DOI
https://doi.org/10.1007/s12072-024-10744-9

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