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Prescriber Specialty Involvement in Medicare Patients With Chronic Hepatitis B

Xiaohan Ying1, Nicole Ng1, Deirdre Reidy1

  • 1Department of Medicine, Weill Cornell Medicine, New York City, New York, USA.

Journal of Viral Hepatitis
|September 9, 2025
PubMed

Insights

Prescriber patterns for chronic hepatitis B (CHB) shifted, with more gastroenterologists and advanced practice providers (APPs) managing care. This trend is crucial for ensuring consistent CHB treatment access amid workforce shortages.

Area of Science:

  • Hepatology and Gastroenterology
  • Health Services Research
  • Public Health

Background:

  • Chronic hepatitis B (CHB) significantly contributes to liver disease morbidity and mortality in the U.S.
  • CHB patients require continuous antiviral therapy and follow-up, yet face access barriers.
  • Understanding prescriber trends is vital for optimizing CHB patient care delivery.

Purpose of the Study:

  • To analyze specialty and geographic trends in healthcare providers managing Medicare patients with CHB.
  • To identify shifts in prescribing patterns for CHB therapies between 2013 and 2021.

Main Methods:

  • Utilized the Medicare Part D database and Rural-Urban Continuum codes.
  • Examined over 2.4 million 30-day prescriptions for CHB therapies from 2013-2021.
  • Analyzed prescriber specialty (Gastroenterology, Advanced Practice Providers, Infectious Disease, Primary Care) and geographic location (metropolitan vs. non-metropolitan counties).

Main Results:

  • Total CHB prescriptions increased by 5.4% annually, with 85% in metropolitan areas.
  • Gastroenterology (GI) and Advanced Practice Provider (APP) prescriptions grew significantly (12.5% and 12.2% annually, respectively).
  • Infectious Disease (ID) prescriptions decreased by 14.0% annually; APPs and Primary Care Providers (PCPs) saw declines in non-metropolitan areas.

Conclusions:

  • A notable shift occurred, with increased involvement of Gastroenterologists and APPs in prescribing CHB medications.
  • The rise in APP management is beneficial given physician shortages, but requires careful integration.
  • Strategies like co-management are needed to ensure consistent CHB care and address potential workforce imbalances.

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