studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1213A
2060
Antiviral treatment for chronic hepatitis B in Australia: a
nationwide analysis of treatment uptake and prescribing
trends according to individual antiviral agent
Jennifer H. MacLachlan 1,2 , Nicole Allard 1,2 , Benjamin C. Cowie 1,2 ;
1 WHO Collaborating Centre for Viral Hepatitis, Doherty Institute
for Infection and Immunity, Melbourne, VIC, Australia; 2 Department
of Medicine, Dentistry and Health Sciences, University of
Melbourne, Melbourne, VIC, Australia
Background: Antiviral treatment for chronic hepatitis B (CHB)
is subsidized through Australia’s national health insurance
scheme, Medicare, with all approved treatments funded for
patients meeting specified virological and disease activity
criteria. However, awareness and uptake of CHB therapy is
low, and prescribing patterns and adherence to treatment
guidelines have not been examined at a population level.
Methods: Aggregate, population-level data regarding expenditure
for CHB treatment through Medicare were obtained
for all approved therapies (adefovir, entecavir, lamivudine,
pegylated interferon, telbivudine, and tenofovir). Numbers of
patients receiving therapy were derived from these data, and
prescribing trends by individual agent were assessed for the
period 2011-2013. Individualized data were also obtained
for 2013 to examine prescribing patterns for combination
antiviral therapy. Results: The number of patients treated for
CHB in Australia increased from 9,000 in 2011 to 10,900
in 2013, for an estimated proportion of all people living with
CHB in 2013 of 5%. Patients receiving recommended first-line
oral therapies represented an increasing majority, with those
receiving entecavir increasing from 44.1% to 46.8% and tenofovir
increasing from 26.3% to 34.6%. Usage of lamivudine
and adefovir decreased, however together these drugs still
represented 17.4% of prescribing expenditure in 2013. Very
small numbers of patients received either telbivudine (36 months, consolidation
duration>12 months and baseline HBV DNA level