New Research Finds Patient Out-of-Pocket Spending Increased for Hepatitis B Medication

Patient out-of-pocket spending increased for the hepatitis B medication entecavir between 2014 and 2018, according to researchers at the University of Minnesota Medical School.

During that time period, patients with high-deductible health plans spent on average $133 per 30-day supply, a cost threshold associated with a more than 50% rate of prescription abandonment, according to the researchers.

“We noticed that some of our patients with chronic hepatitis B were unable to afford entecavir, a first-line generic drug, due to high out-of-pocket costs,” said Thomas Leventhal, MD, ​​a gastroenterologist and hepatologist at the U of M Medical School and M Health Fairview, in a press release. “We wanted to better understand the reasons for this, so we examined trends in the average wholesale price, the average price that pharmacies pay, and spending.”

The research team also found that the increase occurred despite generic manufacturer competition and a marked decline in the price that pharmacies paid for entecavir. By looking at the results, the team concluded that the data illustrate how patients appear to be shielded from the benefits of generic competition for entecavir.

“The artificially high average wholesale price for entecavir is a likely driver of such high out-of-pocket spending, as drugs are often paid for based on a discount of the average wholesale price,” Leventhal said in the press release. “This patient-cost burden commonly benefits supply chain intermediaries—such as pharmaceutical benefit managers (PBMs) and wholesalers—while contributing to drug price inflation.”

More research is necessary to determine the reasons for such high out-of-pocket spending for entecavir, such as a closer look into the practices of pharmacy benefit managers, according to the study authors. These types of findings lead the researchers to designate an example of a medication that could be ripe for market disruption for patients’ benefits.

REFERENCE

U of M research found that patient out-of-pocket spending increased for hepatitis B medication. University of Minnesota. January 24, 2022. Accessed January 26, 2022. https://med.umn.edu/news-events/u-m-research-found-patient-out-pocket-spending-increased-hepatitis-b-medication#:~:text=hepatitis%20B%20medication-,U%20of%20M%20research%20found%20that%20patient%20out%2Dof%2Dpocket,increased%20for%20hepatitis%20B%20medication&text=MINNEAPOLIS%2FST.,for%20hepatitis%20B%20medication%2C%20entecavir