Nationwide evaluation of hepatitis medication prescription patterns and costs in hepatitis B and C care

BACKGROUND: The financial and healthcare burden of hepatitis B and C remains a significant challenge in Iran, despite efforts to control these diseases through vaccination and improved treatment protocols. This study evaluates demographic and geographic distribution, prescription patterns, and medication costs of hepatitis B and C from 2014 to 2019. METHOD: Outpatient prescription data from the Iran Health Insurance Prescription Database, containing hepatitis-related drugs from 2014 to 2019, were analyzed. After excluding irrelevant records, 159,401 prescriptions were evaluated. A defined algorithm identified hepatitis types based on prescribed medications. Association Rule Mining was used to analyze co-prescription patterns. RESULT: A total of 33,900 patients were identified, including 25,042 with hepatitis B, 8717 with hepatitis C, and 141 co-infected with both. Most patients were middle-aged men. Patient numbers peaked in 2017 (total of 13,766 patients), followed by a sharp decline (11,227 patients in 2019), particularly for hepatitis C, from 3296 cases in 2017 to 1410 cases in 2019. Prescriptions decreased overall, with a growing preference for antivirals (e.g., Sofosbuvir, Daclatasvir, and Tenofovir) and declining interferon use. Costs per prescription also decreased over the years. CONCLUSION: While advancements have been made, gaps in diagnosis, access to care, and insurance coverage impede effective management. The findings emphasize the need for comprehensive public health strategies, including enhanced vaccination, better screening, and wider access to antiviral therapies. Policymakers must focus on improving healthcare infrastructure and public education to achieve the 2030 hepatitis elimination targets.