Chronic Hepatitis B Antiviral Long-Term Treatment Cost Calculator

This English page explains long-term oral antiviral drug costs for chronic hepatitis B (CHB, ICD B18.1) in Korea. Chronic hepatitis B has no cure, so antivirals are taken once daily essentially for life; stopping on your own risks a dangerous flare and liver failure. Four high-genetic-barrier oral drugs are first line: entecavir (Baraclude 0.5 mg, original about KRW 3,006/tablet ≈ KRW 1.10 million/year at 100%; generics about KRW 1,970-2,998, roughly 30%+ cheaper), tenofovir disoproxil (Viread / TDF 300 mg, about KRW 2,505/tablet ≈ KRW 0.91 million/year), tenofovir alafenamide (Vemlidy / TAF 25 mg, about KRW 3,139/tablet ≈ KRW 1.15 million/year, safer for kidney/bone), and besifovir (Besivo 150 mg, a Korean-developed drug about KRW 3,403/tablet plus mandatory L-carnitine). Because entecavir and tenofovir are off-patent, the original-vs-generic price gap is the main cost lever; effect and reimbursement criteria are identical. Reimbursement (HIRA notice No. 2026-133) generally requires HBV DNA >= 20,000 IU/mL (HBeAg-positive) or >= 2,000 IU/mL (HBeAg-negative) together with AST/ALT >= 80 IU/L; compensated cirrhosis qualifies at HBV DNA >= 2,000 regardless of liver enzymes. If criteria are not met (immune-tolerant phase, normal ALT, low viral load) the drug is fully non-covered at 100%. The decisive point most patients misunderstand: chronic hepatitis B is NOT a copayment special-case condition. The special-case notice (No. 2026-101) lists only autoimmune hepatitis and primary biliary cirrhosis among liver conditions, not viral hepatitis B (B18) or ordinary cirrhosis, so even when the drug is covered a CHB patient pays the ordinary benefit copay (30% at a pharmacy/clinic, up to 60% at a tertiary outpatient, 20% inpatient), and the medical-expense tax credit keeps its ordinary KRW 7,000,000 cap. Cirrhosis progression does not change this (a medical society is lobbying to add severe cirrhosis). The only way copay drops to 5% is progression to hepatocellular carcinoma (ICD C22), which is a cancer special-case (5% for 5 years from registration) — an outcome of worsening disease, not a goal. The annual out-of-pocket ceiling refunds covered self-pay above the income-tier cap (about KRW 900,000-8,430,000 in 2026), but a ~KRW 200,000-400,000 annual drug copay rarely reaches it on its own; private indemnity insurance reimburses outpatient prescriptions only after a per-visit deductible (KRW 10,000-20,000), so small monthly drug bills often net zero. Prices are 2025-2026 benefit-ceiling figures (Baraclude/Viread/Vemlidy exact; generic and Besivo estimated) you should replace with the actual HIRA tariff. It is planning guidance based on 2026 Korean rules, not medical advice or an insurer decision.