Publicly funded oral chronic hepatitis B treatment patterns in ontario over 16 years: An ecologic study

Abstract

BACKGROUND: Reimbursement for the use of hepatitis B virus (HBV) treatmentshas not been previously reported for public payers.OBJECTIVE: To describe the number of users and total cost of HBV treatmentsover the last 16 years among residents of Ontario, Canada, whowere covered by the public drug program.METHODS: We conducted a repeated cross-sectional study for HBV treatmentsreimbursed by the public drug program in Ontario from January 1,2000, to December 31, 2015. We projected total spending to 2020 based oncurrent utilization trends.RESULTS: HBV drug users per year increased 30-fold, from 132 users in2000 to 4,035 users in 2015. Total spending on HBV treatments increased150-fold, from $136,368 annually in 2000 to $21.0 million in 2015. Thespending on HBV agents is projected to increase by 65%, with an estimateddrug cost of $34.6 million by 2020.CONCLUSIONS: Although not reimbursed as first-line therapy, tenofovirdisoproxil fumarate has become the most commonly reimbursed HBV treatmentand was associated with an increase in HBV treatment use and totalspending. Results of this study found that rapid growth of HBV treatmentsled to a sustained increase in spending for public payers in Ontario.