treatment coverage and drug expenditure in hepatitis c patients from 2013 to 2019: a journey of improving treatment accessibility in malaysia through government-led initiatives

Background: hepatitis c is a public health threat, affecting approximately 1.9% of the malaysian population. objectives: this study demonstrates how a series of initiatives taken by the ministry of health (moh) of malaysia have impacted the treatment coverage and drug expenditure for hepatitis c patients since 2013, the year in which the first directacting antiviral (daa) was introduced in public health institutions. methods: the data were obtained from all the 144 hospitals and 33 primary healthcare centers throughout the country, which were identified to have offered the pharmacological treatment to hepatitis c patients over the last seven years. results: the total number of hepatitis c patients treated each year was shown to increase by more than 10 times, reaching 3,116 in 2019. however, the drug expenditure for hepatitis c relative to the overall health expenditure did not significantly increase over time (p = 0.094). the use of daas was once limited by its exorbitant cost. a remarkable elevation in the number of patients receiving the treatment only took place as of 2016, particularly following the engagement of the moh in endeavors driven by non-profit organizations to enhance the accessibility of daas and the issuance of a compulsory license to ofosbuvir. conclusions: timely decisions of the moh and the judicious use of policy tools were shown to have transformed the landscape of hepatitis c management in malaysia without considerably raising the budgetary pressure. yet, continuous efforts to massively upscale the screening and treatment of the disease are warranted going forward.