S1990 A Global Comparison of Hepatitis B Drug Pricing: US vs the Other G7 Countries and Australia
Bibliographic record
Abstract
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. Conclusion: While the prices of HBV originator medications in the US remain higher than the prices in 7 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 (Table 1). Table 1. - Prices for each drug per country formulary are listed in USD. Generic prices are noted in parentheses Drug Unit (mg) United States Canada France UK Japan Italy Germany Australia Lamivudine 100 16.09 4.13 (1.97) 2.62 (1.38) 3.55 1.67 Adefovir 10 37.89 15.79 18.02 23.37 Tenofovir disoproxil fumarate 300 (245 in Europe) 50.14 (3.65) 14.76 (3.69) 4.71 (4.71) 1.20 10.51 14.50 (7.25) 7.35 (6.34) 3.85 Tenofovir alafenamide fumarate 25 57.66 6.72 17.81 11.38 Entecavir 0.5 54.90 (2.60) 17.12 (3.32) 5.71 (5.71) 15.41 3.94 (0.63) 27.09 (11.24) 1.83 Peginterferon alfa-2a 0.18 1336.10 329.22 169.27 116.76 336.65 316.69 118.50 Emtricitabine/tenofovir disoproxil fumarate 200/300 73.69 (2.34) 22.06 (5.51) 10.90 (5.72) 15.09 17.80 24.91 (4.23) 30.11 (2.41) 1.02
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".