TY - JOUR
T1 - Preferences and feasibility of long-acting technologies for treatment of hepatitis C virus in low- and middle-income countries
T2 - A survey of providers and policymakers
AU - Gupta, Neil
AU - Swindells, Susan
AU - Scarsi, Kimberly K.
AU - Furl, Renae
AU - Thomas, David L.
AU - Weld, Ethel D.
AU - Ofimboudem, Joelle Dountio
AU - Desalegn, Hailemichael
AU - Hamid, Saeed
AU - Rosas, Alethse de la Torre
AU - Miranda, Angelica E.
AU - Owen, Andrew
AU - Rannard, Steve
AU - Hiebert, Lindsey
AU - Sun, Katherine
AU - Ward, John W.
N1 - Publisher Copyright:
© 2024 John Wiley & Sons Ltd.
PY - 2024/5
Y1 - 2024/5
N2 - Long-acting technologies (LATs) for hepatitis C virus (HCV) are under development as a strategy to improve linkage to care, treatment adherence and outcomes. We conducted a survey of HCV treatment prescribers and HCV policymakers in low- and middle-income countries (LMICs) regarding acceptability and feasibility of HCV LATs. We included one-time intramuscular injection, subdermal implant and transdermal patch as potential LAT options. We surveyed participants regarding optimal health system and patient characteristics, concerns, potential barriers, overall feasibility and preferences for HCV LAT as compared to daily oral medication. Overall, 122 providers and 50 policymakers from 42 LMICs completed the survey. Among providers, 93% (113/122) expressed willingness to prescribe LAT and 72% (88/120) of providers preferred LAT if provided at comparable efficacy, safety and cost as current oral treatments. Of providers preferring HCV LAT to daily oral medication, 67% (59/88) preferred injection, 24% (21/88) preferred patch and 9% (8/88) preferred implant. Only 20% (24/122) would prescribe LAT if it were more costly than oral treatment. In regression analysis, no provider characteristics were associated with preference for LAT over oral treatment. Policymakers reported high likelihood that LAT would be included in treatment guidelines (42/50; 84%) and national drug formularies (39/50; 78%) if efficacy, safety and cost were similar to oral treatment. HCV LATs could advance progress to HCV elimination in LMICs by diversifying treatment options to improve treatment coverage and outcomes. Provider preferences from LMICs are a critical consideration in the development of HCV LATs to ensure its early and equitable availability in LMICs.
AB - Long-acting technologies (LATs) for hepatitis C virus (HCV) are under development as a strategy to improve linkage to care, treatment adherence and outcomes. We conducted a survey of HCV treatment prescribers and HCV policymakers in low- and middle-income countries (LMICs) regarding acceptability and feasibility of HCV LATs. We included one-time intramuscular injection, subdermal implant and transdermal patch as potential LAT options. We surveyed participants regarding optimal health system and patient characteristics, concerns, potential barriers, overall feasibility and preferences for HCV LAT as compared to daily oral medication. Overall, 122 providers and 50 policymakers from 42 LMICs completed the survey. Among providers, 93% (113/122) expressed willingness to prescribe LAT and 72% (88/120) of providers preferred LAT if provided at comparable efficacy, safety and cost as current oral treatments. Of providers preferring HCV LAT to daily oral medication, 67% (59/88) preferred injection, 24% (21/88) preferred patch and 9% (8/88) preferred implant. Only 20% (24/122) would prescribe LAT if it were more costly than oral treatment. In regression analysis, no provider characteristics were associated with preference for LAT over oral treatment. Policymakers reported high likelihood that LAT would be included in treatment guidelines (42/50; 84%) and national drug formularies (39/50; 78%) if efficacy, safety and cost were similar to oral treatment. HCV LATs could advance progress to HCV elimination in LMICs by diversifying treatment options to improve treatment coverage and outcomes. Provider preferences from LMICs are a critical consideration in the development of HCV LATs to ensure its early and equitable availability in LMICs.
KW - hepatitis C
KW - long-acting technologies
KW - low- and middle-income countries
KW - treatment
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U2 - 10.1111/jvh.13921
DO - 10.1111/jvh.13921
M3 - Article
C2 - 38545826
AN - SCOPUS:85189561205
SN - 1352-0504
VL - 31
SP - 221
EP - 232
JO - Journal of Viral Hepatitis
JF - Journal of Viral Hepatitis
IS - 5
ER -