title: Reimbursement policies in the Asia-Pacific for chronic hepatitis B.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Division of Gastroenterology and Hepatology, National University Health System, Singapore, Singapore, seng_gee_lim@nuhs.edu.sg.
authors: Seng Gee
authors: SG
authors: Lim
authors: Deepak N
authors: DN
authors: Amarapurkar
authors: Henry Lik-Yuen
authors: HL
authors: Chan
authors: Darrell H
authors: DH
authors: Crawford
authors: Edward J
authors: EJ
authors: Gane
authors: Kwang-Hyub
authors: KH
authors: Han
authors: Sang Hoon
authors: SH
authors: Ahn
authors: Wasim
authors: W
authors: Jafri
authors: Jidong
authors: J
authors: Jia
authors: Jia-Horng
authors: JH
authors: Kao
authors: Laurentius A
authors: LA
authors: Lesmana
authors: C Rinaldi A
authors: CR
authors: Lesmana
authors: Rosmawati
authors: R
authors: Mohamed
authors: Pham Hoang
authors: PH
authors: Phiet
authors: Teerha
authors: T
authors: Piratvisuth
authors: Shiv K
authors: SK
authors: Sarin
authors: Jose D
authors: JD
authors: Sollarno
authors: Yuichiro
authors: Y
authors: Eguchi
authors: Mamun-Al
authors: MA
authors: Mahtab
authors: Keat Hong
authors: KH
authors: Lee
mesh_terms: D000998:Antiviral Agents / Q000191:economics / Q000627:therapeutic use; D001208:Asia; D001315:Australia; D035082:Federal Government; D005762:Gastroenterology / Q000191:economics*; D006077:Government Agencies; D019983:Guideline Adherence / Q000191:economics* / Q000706:statistics & numerical data; D006291:Health Policy; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics* / Q000706:statistics & numerical data; D009520:New Zealand; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires
chemical_list: D000998:Antiviral Agents