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Reimbursement policies in the Asia-Pacific for chronic hepatitis B

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单位: [1]Natl Univ Hlth Syst, Div Gastroenterol & Hepatol, Singapore, Singapore [2]Bombay Hosp & Med Res Ctr, Dept Gastroenterol & Hepatol, Mumbai, Maharashtra, India [3]Chinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R China [4]Chinese Univ Hong Kong, Inst Digest Dis, Hong Kong, Hong Kong, Peoples R China [5]Univ Queensland, Sch Med, Brisbane, Qld, Australia [6]Auckland City Hosp, New Zealand Liver Unit, Auckland, New Zealand [7]Yonsei Univ, Coll Med, Dept Internal Med, Seoul 120749, South Korea [8]Aga Khan Univ, Dept Med, Karachi, Pakistan [9]Capital Med Univ, Beijing Friendship Hosp, Liver Res Ctr, Beijing, Peoples R China [10]Natl Taiwan Univ Hosp, Hepatitis Res Ctr, Taipei, Taiwan [11]Univ Indonesia, Cipto Mangunkusumo Hosp, Fac Med, Dept Internal Med, Jakarta, Indonesia [12]Univ Malaya, Fac Med, Kuala Lumpur, Malaysia [13]Univ Med & Pharm, Dept Immunol & Physiopathol, Ho Chi Minh City, Vietnam [14]Prince Songkla Univ, NKC Inst Gastroenterol & Hepatol, Hat Yai, Thailand [15]Inst Liver & Biliary Sci, New Delhi, India [16]Univ Santo Tomas, Dept Med, Manila, Philippines [17]Saga Med Sch, Ctr Liver, Div Hepatol, Saga, Japan [18]Bangabandhu Sheikh Mujib Med Univ, Dept Hepatol, Dhaka, Bangladesh
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关键词: Hepatitis B Reimbursement Asia Pacific Antiviral therapy

摘要:
There is considerable variation in reimbursement policies in Asian countries and this is likely to have an impact on treatment practice for chronic hepatitis B (CHB). Consequently a survey of leading hepatologists was performed to evaluate such policies and their impact on management of CHB in the Asia Pacific region. A questionnaire was sent to key hepatologists in Asia Pacific for information on CHB reimbursement policy-its nature, coverage, funding source, duration, review strategy and impact on Asia Pacific Association for the Study of the Liver (APASL) CHB guidelines. The results were analysed and described. Leading hepatologists from 16 Asia Pacific countries responded. Almost all of the countries have reimbursement policies but eligibility varied from only a limited group (e.g. civil servants only) to universal access. In most instances reimbursement was from the central government (except China, Pakistan and Hong Kong). Reimbursement policies were usually created by Ministry of Health committees, who received input from medical professionals, although they may not be aware of the APASL guidelines. Policies were limited by available resources, funds and prioritization. Where there was a regular review this occurred between 1 and 5 years. The quantum of reimbursement varied from 50 % in Singapore to 100 % in the majority of other countries. The criteria for treatment reimbursement were based on doctor's opinion alone (Bangladesh, India, Pakistan, Philippines, Singapore and Vietnam) or specific clinical/laboratory criteria in the rest of the countries. In general, most countries offered unlimited duration for reimbursement except Taiwan, Indonesia and Pakistan. Monitoring tests for treatment response were reimbursed in all countries other than Vietnam. Viral resistance was diagnosed by viral or biochemical breakthrough, and viral resistance testing was uncommon. The main rescue therapy was adefovir. Reimbursement policies differed from country to country, the quantum and the proportion of patients who received reimbursement also varied significantly. Asia Pacific countries were able to follow APASL guidelines with variable success based on their reimbursement policies.

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出版当年[2014]版:
大类 | 3 区 医学
小类 | 3 区 胃肠肝病学
最新[2025]版:
大类 | 1 区 医学
小类 | 2 区 胃肠肝病学
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出版当年[2013]版:
Q2 GASTROENTEROLOGY & HEPATOLOGY
最新[2023]版:
Q1 GASTROENTEROLOGY & HEPATOLOGY

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2013版] 出版当年五年平均[2009-2013] 出版前一年[2012版] 出版后一年[2014版]

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第一作者单位: [1]Natl Univ Hlth Syst, Div Gastroenterol & Hepatol, Singapore, Singapore
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