Chronic hepatitis B (CHB) causes significant liver-related morbidity and mortality. Treatment of CHB is cost-effective in the US; however, high out-of-pocket spending on first-line therapy may be a treatment barrier.
Entecavir, a generic drug that is one of the first-line agents used for treatment of CHB, has had a steep decline in the average price that pharmacies pay for the drug (ie, national average drug acquisition cost [NADAC]) because of manufacturer competition. Yet, the list price—which correlates with out-of-pocket spending—has remained high. We assessed trends in the number of manufacturers, average wholesale price, NADAC, and out-of-pocket spending for entecavir among a commercially insured population with CHB between 2014 and 2018.