학술논문

Direct-acting antiviral therapies for hepatitis C infection: global registration, reimbursement, and restrictions
Document Type
Article
Author
Marshall, Alison DWilling, Alex RKairouz, AbeCunningham, Evan BWheeler, AliceO’Brien, NicholasPerera, ViduraWard, John WHiebert, LindseyDegenhardt, LouisaHajarizadeh, BehzadColledge, SamanthaHickman, MatthewJawad, DanielleLazarus, Jeffrey VMatthews, Gail VScheibe, AndrewVickerman, PeterDore, Gregory JGrebely, JasonSargsyants, N.Suleymanova, L.Salkic, N.Simonova, M.Nemeth-Blazic, T.Mravcik, V.Kivimets, K.Salupere, R.Butsashvili, M.Soselia, G.Makara, M.Tolmane, I.Jancorienė, L.Stratulat, S.Flisiak, R.Gheorghe, L.Cernat, R.Lakhov, A.Stanevich, O.Jarcuska, P.Peck-Radosavljevic, M.Robaeys, G.Øvrehus, A.Foster, G.Sutinen, J.Farkkila, M.Rautiainen, H.Vuoti, S.Nikolova, D.Pawlotsky, J.M.Rockstroh, J.Sypsa, V.Papatheodoridis, G.Olafsson, S.Feeney, E.Teti, E.Seguin-Devaux, C.Pocock, J.Reiff, S.McDougall, N.Van der Valk, M.Dalgard, O.Tato Marinho, R.Dillon, J.Peters, E.Bojovic, K.Matičič, M.Kåberg, M.Bruggmann, P.Healy, B.Chong, V.H.Yi, S.Tucker, J.Pasaribu, L.R.Tanaka, J.Ashley, E.A.Abu Hassan, M.R.Mohammed, N.S.Chan, H.K.Gidaagaya, S.Kyi, K.P.Hyung Joon, K.Chin, B.Baladjay, P.C.Kao, J.H.Wansom, T.da Cruz, B.Flower, B.Ehsan, E.Al Mahtab, M.Khandu, L.Bhadoria, A.S.Alavi, M.KC, P.Hamid, S.Biryukov, S.Alymbaeva, D.Alaei, A.Bakieva, S.Flichman, D.Carmo, R.F.Valdez, E.Cortes, C.P.Contreras, F.Teran, E.Velez-Moller, P.Jagnarine, T.Mills, M.Goodman-Meza, D.Sánchez, J.Montenegro-Idrogo, J.J.Lugo Canales, A.M.Davy, J.Alexander, A.Gerona, S.Perazzo, R.Balak, D.Kelly-Hanku, A.Fineanganofo, A.Gane, E.Raymond, N.Debzi, N.Sridharan, K.Waked, I.Turner, D.Shibolet, O.Al Muzaini, A.El Nakib, M.Sheriff, D.S.Brahni, T.Essayagh, T.Essayagh, S.Hjaija, D.Al-Naamani, K.Sanai, F.M.Pasquale, H.Bedri, S.Chakroun, M.Ghrabi, A.Akarca, U.S.Falcao, V.Edmond Gbedo, S.Ouoba, S.Nyabenda, F.Rocher Mbella, M.Mahamat Moussa, A.Youssouf, T.Boniface, Y.Akilimali Shindano, T.Hamida, M.E.Mongo, A.Mapapa, C.Desalegn, H.Embinga, E.L.A.Ndow, G.Nartey, Y.Cisse, M.Djalo, M.A.Mugambi, M.Nyakowa, M.Jeuronlon, M.K.Ngoma, J.Manitrala Ramanampamonjy, R.Naik, K.Soyjaudah, M.D.Filipe, E.Nnakelu, E.Serumondo, J.Mbodj, M.Patino, M.Aalto, M.K.Waweru, P.Dagnra, A.Ocama, P.Maghimbi, A.Hamooya, B.M.Katsidzira, L.Rios, C.Thormann, M.Al Marzooqi, N.Al Rand, H.M.Francois, K.Hamoudi, W.Alkharty, M.Skripo, O.Uka, T.
Source
The Lancet Gastroenterology & Hepatology; April 2024, Vol. 9 Issue: 4 p366-382, 17p
Subject
Language
ISSN
24681253
Abstract
Direct-acting antivirals (DAAs) for hepatitis C virus (HCV) infection have delivered high response rates (>95%) and simplified the management of HCV treatment, permitting non-specialists to manage patients without advanced liver disease. We collected and reviewed global data on the registration and reimbursement (government subsidised) of HCV therapies, including restrictions on reimbursement. Primary data collection occurred between Nov 15, 2021, and July 24, 2023, through the assistance of a global network of 166 HCV experts. We retrieved data for 160 (77%) of 209 countries and juristrictions. By mid-2023, 145 (91%) countries had registered at least one of the following DAA therapies: sofosbuvir–velpatasvir, sofosbuvir–velpatasvir–voxilaprevir, glecaprevir–pibrentasvir, sofosbuvir–daclatasvir, or sofosbuvir. 109 (68%) countries reimbursed at least one DAA therapy. Among 102 low-income and middle-income countries (LMICs), 89 (87%) had registered at least one HCV DAA therapy and 53 (52%) reimbursed at least one DAA therapy. Among all countries with DAA therapy reimbursement (n=109), 66 (61%) required specialist prescribing, eight (7%) had retreatment restrictions, seven (6%) had an illicit drug use restriction, five (5%) had an alcohol use restriction, and three (3%) had liver disease restrictions. Global access to DAA reimbursement remains uneven, with LMICs having comparatively low reimbursement compared with high-income countries. To meet WHO goals for HCV elimination, efforts should be made to assist countries, particularly LMICs, to increase access to DAA reimbursement and remove reimbursement restrictions—especially prescriber-type restrictions—to ensure universal access.