1.

hepatitis B

1.1 antiviral untuk hepatitis B yang tersedia di negara X

Availability of antiviral drugs for the treatment of Hepatitis B in Pakistan are
adefovir, lamivudine, entecavir, telbivudine, entecavir, standard and pegylated
interferon and thymosin. Treatment may be initiated with any of the above agents in
naïve patients but a potent drug with the lowest rate of genotypic resistance is preferred
(e.g. entecavir or tenofovir). Lamivudine or telbivudine are less favoured due to their
high rates of resistance. Tenofovir, a potent drug with low rates of resistance, is
preferred over adefovir. 1

1.2 harga pengobatan termasuk antiviral

For HBV, the cost of one tablet daily was Rs25; so for one month the cost would
be Rs1050, and for one year it would be Rs12600/patient. When multiplied by the
number (454) of cases who were treated, the cost comes to Rs5.7 million. Adding these,
the money spent on treatment cost comes to Rs74 million. With a few more millions
for the diagnostic tests, the cost would escalate to approximately Rs100 million. The
government thus spent about Rs100 million on the treatment of about 8000 cases with
an ultimate response in only 1135 cases. 2 (harga tahun 2013)

1.3 angka pengobatan hepatitis B di negara X

1.4 efek pengobatan terhadap prevalensi hepatitis B di negara X

2. hepatitis C

2.1 antiviral untuk hepatitis C yang tersedia di negara X

Licensed treatments for HCV infection in Pakistan include pegylated and
standard interferon, ribavirin, and DAA drugs (eg, sofosbuvir).3 The first-line treatment
for chronic HCV infections in Pakistan is changing to the new DAAs. This includes
SOF + RBV, which has been one of the registered and widely available DAAs in
Pakistan since November.4

2.2 harga pengobatan termasuk antiviral

 Pakistan’s Ministry of NHSRC registered Sovaldi (branded sofosbuvir) at a
price of $330 per month, in 2015 which was a 98% decrease from the original price
when launched in the United States in 2013. Subsequently, generics were introduced at
a price of $25 per month. In 2017, public sector, Provincial Hepatitis Programs are
procuring generic sofosbuvir at a further discounted price of $15 per month which, to
our knowledge, is the lowest price in the world. Recently Daclatasvir is also registered
and easily available at a price of $30 per month.3 The Government of Pakistan has made
a commitment to provide diagnosis, treatment and care to patients infected by HCV
free of cost in all provinces, through four regional Hepatitis Prevention and Control
programmes.5

2.3 angka pengobatan hepatitis C di negara X dan efek pengobatan terhadap

prevalensi hepatitis C di negara X
A marked scale-up in patients treated with DAAs in Pakistan was observed from
2015 (approximately 65,000 patients) to 2016 (approximately 161,000 patients), due in
part to drastically reduced prices for DAAs.6

Refeences
1. Abbas Z, Jafri W, Hamid S. Management of Hepatitis B: Pakistan Society for the
Study of Liver Diseases (PSSLD) Practice Guidelines. Journal of the College of
Physicians and Surgeons Pakistan. 2010; 20(3): 198-20.
2. Qureshi H, Mohamud BK, Alam SE, Arif A, Ahmed W. Treatment of hepatitis B
and C through national programme-an audit. J Pak Med Assoc .2013.
3. Mahmood H, Qureshi H, Glass N, Averhoff F. Optimizing medicines and treatment
regimens for hepatitis C patients in Pakistan. World Hepatitis Summit. 2017.
4. Khaliq S, Raza SM. Current Status of Direct Acting Antiviral Agents against
Hepatitis C Virus Infection in Pakistan. Medicina.2018;54(80).
5. Ayuob HH, Abu-Raddad LJ. Treatment as prevention for hepatitis C virus in
Pakistan: mathematical modelling projections. BMJ Open. 2019;9.
6. (Mahmud S, Al Kaaani Z, Abu-Raddad LJ. Characterization of the hepatitis C virus
epidemic in Pakistan. BMC Infectious Disease. 2019:19:809.)