I have chronic hepatitis B. What does this change mean for me?

You can now discuss antiviral treatment directly with your GP without needing a specialist referral first. Entecavir and tenofovir are subsidised on the PBS, so cost should not be a barrier if you hold a Medicare card. Your GP will likely want recent liver function and hepatitis B DNA tests before starting treatment. If you have not been reviewed in the past 12 months, now is a good time to book.

Why were GPs excluded from prescribing these drugs for eleven years?

When entecavir and tenofovir were added to the PBS Section 100 Highly Specialised Drugs Program in 2015, specialist accreditation was set as a prescribing condition — a common approach for newly listed drugs with complex monitoring requirements and limited GP prescribing experience at the time. The removal in 2026 reflects accumulated clinical experience and the persistent reality that specialist-only prescribing pathways were creating access barriers for the communities most affected by chronic hepatitis B.

GPs can now prescribe hepatitis B antivirals — no specialist sign-off needed

What just happened

In a change that should matter to anyone living with chronic hepatitis B, the Australian Department of Health removed an eleven-year-old administrative hurdle this week: GPs and nurse practitioners no longer need specialist accreditation to prescribe entecavir and tenofovir under the PBS.

That accreditation requirement had been in place since 2015, the year these drugs were first listed on the Section 100 Highly Specialised Drugs Program. For over a decade, a patient with chronic hepatitis B who did not have a specialist relationship — a gastroenterologist, hepatologist, or infectious disease physician — could not access PBS-subsidised antiviral treatment through their GP alone. The drug existed. The subsidy existed. The prescription could not be written.

The result was predictable. Only 42% of eligible Australians were receiving antiviral treatment at the time of this announcement. Approximately 230,000 Australians live with chronic hepatitis B, according to Hepatitis Australia — which means roughly 130,000 people who could benefit from treatment are currently not receiving it.

The both-and

Why this matters beyond the prescription pad

Chronic hepatitis B is not a mild nuisance. Untreated, it is a leading driver of cirrhosis and hepatocellular carcinoma — liver cancer — in Australia. The treatment gap is not abstract: it is the gap between a person who develops liver cancer in their fifties and the same person who, had treatment been accessible earlier, might have had a very different outcome.

The burden of chronic hepatitis B in Australia sits disproportionately in communities that already face structural access barriers. ASHM data consistently shows higher prevalence in people born in the Asia-Pacific region, sub-Saharan Africa, and Pacific Island nations — communities that are more likely to have a regular GP relationship than a specialist gastroenterologist. This is not a coincidence; it is a consequence of how specialist-only prescribing paths intersect with the geography and economics of specialist access. A patient in outer-suburban Melbourne or western Sydney with chronic hepatitis B faces a very different wait for a public gastroenterology appointment than someone in a leafy inner suburb.

Removing the accreditation hurdle does not guarantee these communities receive treatment. But it removes a structural obstruction that existed nowhere else in the clinical chain. GPs have always been able to diagnose chronic hepatitis B, order the monitoring tests, and counsel patients about the risks of untreated infection. They simply could not write the script. That is now changed.

What the policy change does not fix

The change is meaningful, but it is not sufficient on its own.

GPs will need to be confident managing chronic hepatitis B — monitoring viral load, liver function tests, and hepatocellular carcinoma surveillance — before prescribing. ASHM guidelines provide the clinical framework, but familiarity with those guidelines varies across the general practice workforce. Some GPs will need professional development and collegial support before they are comfortable taking on this role, rather than defaulting reflexively to a specialist referral they no longer need.

There is also the persistent challenge of reaching the untested and undiagnosed. The 42% treatment rate only counts people who already know they have chronic hepatitis B. Population estimates suggest a meaningful proportion of infected Australians have not been tested, particularly in communities where hepatitis B carries social stigma and where an asymptomatic infection can make testing feel unnecessary — “I look fine, why would I need a blood test for that?”

Removing the prescribing barrier is the right move. The gap between eligibility and treatment will only close if GPs are also proactively testing, proactively discussing, and proactively reaching into the populations where the burden sits.

My two cents

If you were born in the Asia-Pacific, sub-Saharan Africa, or the Pacific Islands — or if you have a parent from those regions — and you have not been tested for hepatitis B, this is worth raising with your GP at your next visit. Hepatitis B is predominantly transmitted vertically (mother to child at birth) and horizontally in early childhood, meaning people carry it into adulthood without ever having been unwell. The test is a simple blood test — having bloods taken is quick and can be done at any pathology collection centre.

If you already know you have chronic hepatitis B and are not on treatment, ask your GP specifically about entecavir or tenofovir. The prescribing rules have just changed. Whether treatment is appropriate for you depends on your viral load, liver function, and a few other factors — but the conversation no longer requires a specialist appointment before it can begin.

Verdict: yes — a quiet but meaningful access reform; if hepatitis B is in your family or geographic background, raising it with your GP just got easier.

Sources cited

Government scraps accreditation hurdle for hepatitis B prescribing — AusDOC, 3 September 2026. https://www.ausdoc.com.au/news/government-scraps-accreditation-hurdle-for-hepatitis-b-prescribing/
Hepatitis Australia — understanding hepatitis B. https://www.hepatitisaustralia.com/hepatitis-b
ASHM — hepatitis B management guidelines and resources. https://ashm.org.au/resources/hepatitis-b-resources/