Unblocking Barriers of Access to Hepatitis C Treatment in China: Lessons Learned from Tianjin

Background: The high price is a critical barrier of access to new direct-anting-antiviral (DAA) therapies for hepatitis C for both the patients and the society. Many countries continue to face the challenge of financing such expensive medicines. Such examples include both high-income and middle-inco...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Peiwen Zhang, Ran Guo, Jun Lian, Mengjia Zhi, Chengzhen Lu, Weishen Wu, Lihong Wang, Polin Chan, Zhongdan Chen, Jing Sun
Formato:	article
Lenguaje:	EN
Publicado:	Ubiquity Press 2020
Materias:	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/a6f2448d5e6a4a14a56c60a6e6a57089
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:a6f2448d5e6a4a14a56c60a6e6a57089
record_format	dspace
spelling	oai:doaj.org-article:a6f2448d5e6a4a14a56c60a6e6a570892021-12-02T10:33:36ZUnblocking Barriers of Access to Hepatitis C Treatment in China: Lessons Learned from Tianjin2214-999610.5334/aogh.2763https://doaj.org/article/a6f2448d5e6a4a14a56c60a6e6a570892020-04-01T00:00:00Zhttps://annalsofglobalhealth.org/articles/2763https://doaj.org/toc/2214-9996Background: The high price is a critical barrier of access to new direct-anting-antiviral (DAA) therapies for hepatitis C for both the patients and the society. Many countries continue to face the challenge of financing such expensive medicines. Such examples include both high-income and middle-income countries. Existing evidence about the efforts of China to address this challenge is limited. To our knowledge, this is the first detailed description of a novel financing model and comprehensive analysis of its impact on patient financial burden of hepatitis C treatment in China. Objective: To examine the evolution of approaches to navigating patients’ barriers of access to DAA-based treatment of hepatitis C in Tianjin City, China. Methods: Review of publicly available literature, including published and grey literature. Conduct on-site data extraction and key informant interview. The patient financial burden of hepatitis C treatment was analyzed. The financial burden of hepatitis C patients with different treatment models and health insurance financing models was measured by calculating the number of annual income to cover patient out-of-pocket (OOP) expenditure for the standard treatment course accordingly. Findings: Tianjin is the first area to pilot a capitated provider payment program for the treatment of hepatitis C. Through which, the retirees and employees spend 0.7 and 1.0 months of their salary, and residents spend 5.6-6.8 months of their salary for the treatment, the financial burden of patients were much relieved. By the end of March 2019, the first-year pilot program had 876 hepatitis C patients registered the new insurance coverage and treated in Tianjin. Conclusions: The study showed that the financial barriers of access to new hepatitis C treatment for patients could be unblocked with government commitment and novel financing models. International experiences demonstrated that centralized bulk procurement is a good leverage for price negotiation, primarily when using innovative payment approaches. To replicate the initial success of Tianjin, continued efforts are needed for stronger strategic price negotiation, preferably at central level. The case of Tianjin brings implications to the other areas of China and even other developing countries that government commitment, novel financing model and pooled procurement are critical elements of stronger purchasing power and a better secure of treatment.Peiwen ZhangRan GuoJun LianMengjia ZhiChengzhen LuWeishen WuLihong WangPolin ChanZhongdan ChenJing SunUbiquity PressarticleInfectious and parasitic diseasesRC109-216Public aspects of medicineRA1-1270ENAnnals of Global Health, Vol 86, Iss 1 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270
spellingShingle	Infectious and parasitic diseases RC109-216 Public aspects of medicine RA1-1270 Peiwen Zhang Ran Guo Jun Lian Mengjia Zhi Chengzhen Lu Weishen Wu Lihong Wang Polin Chan Zhongdan Chen Jing Sun Unblocking Barriers of Access to Hepatitis C Treatment in China: Lessons Learned from Tianjin
description	Background: The high price is a critical barrier of access to new direct-anting-antiviral (DAA) therapies for hepatitis C for both the patients and the society. Many countries continue to face the challenge of financing such expensive medicines. Such examples include both high-income and middle-income countries. Existing evidence about the efforts of China to address this challenge is limited. To our knowledge, this is the first detailed description of a novel financing model and comprehensive analysis of its impact on patient financial burden of hepatitis C treatment in China. Objective: To examine the evolution of approaches to navigating patients’ barriers of access to DAA-based treatment of hepatitis C in Tianjin City, China. Methods: Review of publicly available literature, including published and grey literature. Conduct on-site data extraction and key informant interview. The patient financial burden of hepatitis C treatment was analyzed. The financial burden of hepatitis C patients with different treatment models and health insurance financing models was measured by calculating the number of annual income to cover patient out-of-pocket (OOP) expenditure for the standard treatment course accordingly. Findings: Tianjin is the first area to pilot a capitated provider payment program for the treatment of hepatitis C. Through which, the retirees and employees spend 0.7 and 1.0 months of their salary, and residents spend 5.6-6.8 months of their salary for the treatment, the financial burden of patients were much relieved. By the end of March 2019, the first-year pilot program had 876 hepatitis C patients registered the new insurance coverage and treated in Tianjin. Conclusions: The study showed that the financial barriers of access to new hepatitis C treatment for patients could be unblocked with government commitment and novel financing models. International experiences demonstrated that centralized bulk procurement is a good leverage for price negotiation, primarily when using innovative payment approaches. To replicate the initial success of Tianjin, continued efforts are needed for stronger strategic price negotiation, preferably at central level. The case of Tianjin brings implications to the other areas of China and even other developing countries that government commitment, novel financing model and pooled procurement are critical elements of stronger purchasing power and a better secure of treatment.
format	article
author	Peiwen Zhang Ran Guo Jun Lian Mengjia Zhi Chengzhen Lu Weishen Wu Lihong Wang Polin Chan Zhongdan Chen Jing Sun
author_facet	Peiwen Zhang Ran Guo Jun Lian Mengjia Zhi Chengzhen Lu Weishen Wu Lihong Wang Polin Chan Zhongdan Chen Jing Sun
author_sort	Peiwen Zhang
title	Unblocking Barriers of Access to Hepatitis C Treatment in China: Lessons Learned from Tianjin
title_short	Unblocking Barriers of Access to Hepatitis C Treatment in China: Lessons Learned from Tianjin
title_full	Unblocking Barriers of Access to Hepatitis C Treatment in China: Lessons Learned from Tianjin
title_fullStr	Unblocking Barriers of Access to Hepatitis C Treatment in China: Lessons Learned from Tianjin
title_full_unstemmed	Unblocking Barriers of Access to Hepatitis C Treatment in China: Lessons Learned from Tianjin
title_sort	unblocking barriers of access to hepatitis c treatment in china: lessons learned from tianjin
publisher	Ubiquity Press
publishDate	2020
url	https://doaj.org/article/a6f2448d5e6a4a14a56c60a6e6a57089
work_keys_str_mv	AT peiwenzhang unblockingbarriersofaccesstohepatitisctreatmentinchinalessonslearnedfromtianjin AT ranguo unblockingbarriersofaccesstohepatitisctreatmentinchinalessonslearnedfromtianjin AT junlian unblockingbarriersofaccesstohepatitisctreatmentinchinalessonslearnedfromtianjin AT mengjiazhi unblockingbarriersofaccesstohepatitisctreatmentinchinalessonslearnedfromtianjin AT chengzhenlu unblockingbarriersofaccesstohepatitisctreatmentinchinalessonslearnedfromtianjin AT weishenwu unblockingbarriersofaccesstohepatitisctreatmentinchinalessonslearnedfromtianjin AT lihongwang unblockingbarriersofaccesstohepatitisctreatmentinchinalessonslearnedfromtianjin AT polinchan unblockingbarriersofaccesstohepatitisctreatmentinchinalessonslearnedfromtianjin AT zhongdanchen unblockingbarriersofaccesstohepatitisctreatmentinchinalessonslearnedfromtianjin AT jingsun unblockingbarriersofaccesstohepatitisctreatmentinchinalessonslearnedfromtianjin
_version_	1718397073962827776

Unblocking Barriers of Access to Hepatitis C Treatment in China: Lessons Learned from Tianjin

Ejemplares similares