Jing Sun
Chinese Academy of Medical Sciences and Peking Union Medical College, China
Posters & Accepted Abstracts: Clin Infect Dis
Background: Direct-acting antivirals (DAAs) for hepatitis C treatment in China became available since 2017. Multiple policy changes were adopted to support access scale-up. Methods We described the number of standard DAA treatment at both national and provincial levels in China from 2017 to 2021. We performed interrupted time series analysis to estimate the level and trend changes of the monthly number of standard DAA treatment at national level. We also adopted the latent class trajectory model (LCTM) to form clusters of the provinces with similar levels and trends of number of treatment, and to explore the potential enablers of the scale-up of DAA treatment at provincial level. Results The number of 3-month standard DAA treatment at national level increased to 49 592 in 2021. The national price negotiation at the end of 2019 resulted in DAA inclusion by the national health insurance in January 2020. In that month, the number of treatment increased 3 668 person-times (p<0.05). Provinces that had piloted DAA price negotiations before the national negotiation and that had explored integration of hepatitis service delivery with prevention and control programme of hepatitis C within the existing services demonstrated earlier and faster scale-up of treatment. Conclusions Central negotiations to reduce prices of DAA drugs resulted in inclusion of DAA drugs under the universal health insurance, and this contributed to improving DAA treatment in China. However, the current treatment rates are still far below the global target. Affordability of medicines is not the only barrier for treatment scale-up. Availability of integrated health service delivery within the existing health system, inclusion of testing and treatment to reach the different population groups including the vulnerable and at-risk individuals, accessibility of services at different levels of healthcare facilities, and capacities to deliver services particularly at the primary care by non-specialists are critical strategies to further accelerate scale-up towards elimination of hepatitis C by 2030. Key words: Direct-acting antivirals, hepatitis C, treatment, China
Clinical Infectious Diseases: Open Access received 49 citations as per Google Scholar report
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