Barriers to accessing hepatitis B medication: a qualitative study from the USA and Canada

BMJ Open. 2024 May 20;14(5):e080658. doi: 10.1136/bmjopen-2023-080658.

Abstract

Objectives: To collect and document the numerous barriers that people living with hepatitis B (PLHB) encounter when trying to access their hepatitis B virus (HBV) medications.

Design: Researchers collected qualitative data through 24 online interviews. The semistructured interview questions focused on the impact that HBV has on different aspects of daily life (physical, emotional and social), personal experiences managing their infection, HBV treatment experiences and interactions with healthcare providers.

Setting: All interviews occurred over Zoom.

Participants: The participant cohort consisted of 12 males and 12 females. 63% of all participants represented communities of colour (37% white, 17% black/African/African American and 46% Asian/Asian American). Most of the participants were on antiviral treatment at the time of the study (62%). Participants were PLHB (self-reported), ≥18 years old, living in the USA or Canada and spoke English.

Results: Participants reported several barriers to accessing medicine among PLHB including financial barriers, health insurance and pharmacy preauthorisation process and other intangible barriers like lack of access to reliable patient-friendly information and stigma. The identified barriers to accessing HBV medication impacted patients' continuity of care.

Conclusions: Access to medicine is essential to improving health outcomes. PLHB experience significant barriers to accessing HBV antivirals at different levels. Patient-related, physician-related and healthcare system barriers were identified as themes contributing to antiviral access challenges. More research is needed to identify strategies to improve access to HBV medications.

Keywords: chronic disease; infectious diseases; medication adherence; qualitative research; quality of life.

MeSH terms

  • Adult
  • Aged
  • Antiviral Agents* / therapeutic use
  • Canada
  • Female
  • Health Services Accessibility*
  • Hepatitis B* / drug therapy
  • Hepatitis B, Chronic / drug therapy
  • Hepatitis B, Chronic / psychology
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Qualitative Research*
  • Social Stigma
  • United States
  • Young Adult