New York-Presbyterian / Weill Cornell Medical Center New York, NY
Leah Yao, MD1, Xiaohan Ying, MD1, Arun B.. Jesudian, MD2, Stephen E. Congly, MD, MSc3 1New York-Presbyterian / Weill Cornell Medical Center, New York, NY; 2Weill Cornell Medicine, New York, NY; 3University of Calgary Cumming School of Medicine, Calgary, AB, Canada
Introduction: A significant component of healthcare spending in the United States is the cost of drugs; the cost of medications in the US may triple that of other countries. As there is currently no cure for hepatitis B (HBV), patients often require potentially cost-prohibitive lifelong antiviral treatment. This cross-sectional study aims to investigate the current price differences between oral HBV antiviral therapies in the US as compared to the other G7 countries and Australia.
Methods: Publicly available drug formularies for Canada, UK, Japan, France, Germany, Italy, and Australia were used to collect 2024 prices for 7 HBV medications (lamivudine, adefovir, tenofovir disoproxil fumarate (TDF), tenofovir alafenamide fumarate, entecavir, peginterferon alfa-2a, emtricitabine/TDF). Foreign currencies were converted to US dollars based on the conversion rate on January 1st, 2024. US prices were obtained from UpToDate®’s listed representative average wholesale price.
Results: US prices for HBV originator medications were on average 4.71x the prices in the non-US G7 countries and Australia. Lamivudine costs $16.09 per dosage unit in the US, whereas it ranges between $1.67 and $4.13 among comparison countries. Similarly, adefovir costs $37.89 in the US, compared to $15.79-23.37 globally, TDF $50.14 vs. $1.20-$14.76, tenofovir alafenamide fumarate $57.66 vs. $6.72-17.81, entecavir $54.90 vs. $1.83-$17.12, peginterferon alfa-2a $1336.10 vs. $116.76-$336.65, emtricitabine/TDF $73.69 vs. $0.90-$30.11.
US generic HBV drug prices for TDF, entecavir, and emtricitabine/TDF were on average 44% cheaper than the average generic prices for those medications in Canada, France, Japan, Italy, and Germany. Per dosage unit, TDF costs $3.65 in the US compared to $3.69-$7.25 among comparison countries. Similarly, entecavir costs $2.60 vs. $0.63-11.24 globally and emtricitabine/TDF $2.34 vs. $2.41-$5.72 globally.
Discussion: While the prices of HBV originator medications in the US remain higher than the prices in seven other major industrial countries, the introduction of generic medications for HBV has significantly lowered the cost of treatment for patients in the US compared to other countries. With a greater proportion of generic HBV medications now being prescribed in the US, US healthcare spending on HBV treatment may decrease over time compared to other countries.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Leah Yao indicated no relevant financial relationships.
Xiaohan Ying indicated no relevant financial relationships.
Arun Jesudian: Bausch Health – Consultant. Madrigal Pharmaceuticals – Speakers Bureau. Novo Nordisk – Advisor or Review Panel Member, Consultant. Orphalan – Advisor or Review Panel Member, Consultant. Salix Pharmaceuticals – Consultant, Speakers Bureau.
Leah Yao, MD1, Xiaohan Ying, MD1, Arun B.. Jesudian, MD2, Stephen E. Congly, MD, MSc3. P4624 - A Global Comparison of Hepatitis B Drug Pricing: US vs the Other G7 Countries and Australia, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
