Assessing pricing and affordability of HBV treatment in Asia–Pacific region: a barrier to elimination
Issued Date
2025-01-01
Resource Type
ISSN
19360533
eISSN
19360541
Scopus ID
2-s2.0-85217847316
Journal Title
Hepatology International
Rights Holder(s)
SCOPUS
Bibliographic Citation
Hepatology International (2025)
Suggested Citation
Chen J., Jia J., Zhuang H., Zhang W., Yang J.M., Tanwandee T., Payawal D., Hamid S., Sarin S.K., Omata M., Wang G., Lau G., Apasl Viral Elimination Task Force Assessing pricing and affordability of HBV treatment in Asia–Pacific region: a barrier to elimination. Hepatology International (2025). doi:10.1007/s12072-024-10744-9 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/105411
Title
Assessing pricing and affordability of HBV treatment in Asia–Pacific region: a barrier to elimination
Author's Affiliation
The Catholic University of Korea, St. Vincent's Hospital
Siriraj Hospital
Peking University First Hospital
Peking University International Hospital
Institute of Liver and Biliary Sciences
Chinese University of Hong Kong, Faculty of Medicine
Beijing Friendship Hospital, Capital Medical University
The Aga Khan University
Fudan University
Peking University Health Science Center
Cardinal Santos Medical Center
Yamanashi Hospitals (Central and Kita) Organization
Humanity and Health Clinical Trial Center
Siriraj Hospital
Peking University First Hospital
Peking University International Hospital
Institute of Liver and Biliary Sciences
Chinese University of Hong Kong, Faculty of Medicine
Beijing Friendship Hospital, Capital Medical University
The Aga Khan University
Fudan University
Peking University Health Science Center
Cardinal Santos Medical Center
Yamanashi Hospitals (Central and Kita) Organization
Humanity and Health Clinical Trial Center
Corresponding Author(s)
Other Contributor(s)
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.