Preparing Practices for the Next Era of Hepatitis B Care

In "Preparing Practices for the Next Era of Hepatitis B Care," our experts close the series by outlining what practices, payers, and patients each need to do next.

Dr. Chung asks what operational changes practices should prioritize to prepare for an expanding hepatitis B treatment landscape, and closes with a broader question about the most important remaining barriers to realizing functional cure at scale, spanning testing, payer policy, and patient engagement.

Dr. Gish says embracing bepirovirsen as a major step forward matters, but so does building infrastructure to manage these patients, noting that some of his own clinics are booked four months out, which is not workable for launching a complex new therapy. He believes practices need to train physician colleagues, nurse practitioners, and physician assistants, prepare patients to use telemedicine, and lean on specialty pharmacies and infusion centers as partners in this expanding treatment model.

Asked about the biggest remaining barriers, Dr. Gish offers five interconnected priorities. First is test-and-treat, extending the same urgency already applied to hepatitis C and HIV so patients are not allowed to get sicker before treatment begins, while also taking stigma, discrimination, and quality of life seriously through shared decision-making. Second is embedding quantitative surface antigen testing into every patient's workup, alongside emerging tests like quantitative HBV RNA and correlated antigen. Third is using the functional cure concept itself to bring patients into treatment and prepare them for that outcome. Fourth is community education about this hope and progress. Together, he says, these build toward a fifth pillar: growing patient interest in treatment once they understand finite therapy and functional cure are real possibilities.

Dr. Gish closes by highlighting the Hepatitis B Foundation's advocacy work on payer policy, treatment access, and patient storytelling, calling it a central pillar supporting this broader five-part structure. Dr. Chung thanks Dr. Gish for his insights before concluding the program.

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