Hepatitis B and C Antivirals Abroad: Where Your Prescription Survives the Border

Your antiviral regimen works at home, but crossing a border can snap the supply chain. Here is what actually happens to hepatitis B and C prescriptions abroad.

Hepatitis B and C antivirals abroad: what you need to know

Direct-acting antivirals (DAAs) for hepatitis C can cure over 95% of infections, yet millions of people on treatment interrupt their course every year^[1] because they cannot obtain the same drug in the country they are visiting. For hepatitis B, where tenofovir or entecavir suppresses the virus indefinitely, even a two-week gap can trigger viral rebound. The prescription continuity problem is not theoretical.

This guide covers the brand-name and registration differences for direct-acting antivirals across the EU, US, India and other key regions; the subsidy and generic-pricing models that decide whether your refill costs $40 or $4,000; and the documentation that prevents customs from interrupting your treatment course mid-trip. For hepatitis B, it covers tenofovir and entecavir continuity, which has a very different supply picture from hepatitis C.

Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Consult your hepatologist or treating physician before making any changes to your antiviral regimen or travel plans.

Why the same drug is a different drug in another country

Sofosbuvir/ledipasvir (Harvoni), sofosbuvir/velpatasvir (Epclusa), and glecaprevir/pibrentasvir (Maviret) are registered under different brand names across jurisdictions^[2] and are not always stocked in every pharmacy. In low- and middle-income countries, generic versions manufactured by Cipla, Mylan, or Hetero are sometimes the only available formulation. Knowing the INN (International Nonproprietary Name) of your medication is the single most practical step you can take before you fly.

Tenofovir disoproxil fumarate (TDF) and entecavir for hepatitis B are widely generic and cheaper to source abroad than many travellers expect. The bigger issue is the prescription: most countries require a local doctor's order to dispense antivirals, even in a pharmacy that physically has stock.

Countries where hepatitis C treatment is subsidised for visitors

Egypt runs one of the most aggressive hepatitis C elimination programmes in the world. Generic sofosbuvir-based regimens cost under $10 (~€9) per month^[3] through national treatment centres, and foreign nationals can access treatment through the public system with a passport and a confirmed diagnosis. The barrier is bureaucratic rather than financial.

India has become the de facto source for low-cost generic DAAs. A 12-week course of sofosbuvir/velpatasvir typically costs ₹40,000–60,000 (~$475–$715 / ~€440–€660)^[4] at a licensed pharmacy in Mumbai or Delhi, compared with tens of thousands of euros in many higher-income countries. You need a prescription from a registered Indian physician, which hepatology clinics in major cities will issue after reviewing prior treatment records.

Within Europe, EHIC and GHIC holders can access necessary ongoing treatment through public systems in EU/EEA countries, but "necessary" is interpreted differently by each national health authority. France and Germany generally cover continuation of an established hepatitis B or C regimen under the reciprocal healthcare agreement. Spain and Portugal typically require patients to pay upfront at a pharmacy and claim reimbursement, which can take weeks.^[5]

Countries where supply is the real problem, not cost

The stock issue. Sub-Saharan African countries with national hepatitis programmes, including Nigeria, Kenya, and Ethiopia, face chronic supply interruptions. Approved DAAs exist on paper but disappear from pharmacy shelves for weeks at a time. If your itinerary includes extended stays in these regions, carry a supply from home that covers your full trip plus a two-week buffer.

The import issue. Most countries permit personal-use quantities of prescription medication without a special permit, typically a 90-day supply. But several countries, including Japan, the UAE, and Indonesia, apply strict import controls^[6] that can catch antiviral packages at customs. Carry the original pharmacy labelling, a letter from your prescribing physician, and a copy of your most recent viral load result. A medication import rules check specific to your destination is essential at least six weeks before departure.

The cold-chain problem. Standard DAAs and tenofovir tablets do not require refrigeration. However, if you are on a pegylated interferon regimen (still used in some lower-resource settings for hepatitis B), you need reliable cold storage throughout transit. Hotel room minibars do not qualify.

Getting a local prescription when yours runs out

A gastroenterologist or hepatologist in any country can prescribe antivirals if you can demonstrate an active, confirmed diagnosis. Bring printed copies of your most recent liver function tests, viral genotype report, and treatment history. An International Patient Summary (IPS) structured to the HL7 FHIR standard is readable by clinical systems in over 30 countries and removes the translation barrier. Without it, a foreign physician must re-diagnose from scratch, which takes time you may not have.^[7]

In Thailand, private hepatology clinics in Bangkok (Bumrungrad International Hospital, Bangkok Hospital) will see walk-in patients and issue prescriptions same-day with adequate documentation. The consultation fee runs approximately ฿1,500–3,000 (~$42–$83 / ~€39–€76).

In South Korea, the National Health Insurance (NHIS) system does not cover foreign nationals for outpatient medication unless they hold a long-stay visa. Private prescriptions are issued at university hospital hepatology departments for a consultation fee of approximately ₩80,000–150,000 (~$59–$110 / ~€55–€102).

What travel insurance actually covers

Standard travel insurance policies classify hepatitis B and C as pre-existing conditions and exclude routine prescription costs. A policy that excludes medication supply disruption^[8] will not pay for an emergency pharmacy run when your pills run out. What good policies do cover is an acute hepatic decompensation or a hospitalisation triggered by viral rebound. Check the policy wording for "acute episode" definitions before purchasing.

International private medical insurance (IPMI) with a chronic-disease rider is a different product. Several IPMI providers will cover ongoing DAA prescriptions if the condition was declared at underwriting and the insurer agreed to cover it, usually with a premium loading. This is the coverage type worth seeking if you travel for more than 30 days per year.

A practical pre-departure checklist

Confirm INN and local brand names. Ask your pharmacist for the generic name of your regimen. Research availability in your destination country before you leave.

Carry enough supply, plus a buffer. For a trip under 90 days, bring your full course plus 14 extra days. For longer trips, arrange a refill strategy before departure.

Prepare a physician letter. Request a letter on headed paper stating your diagnosis (ICD-10 code), current regimen, dose, and treatment duration. Have it translated if your destination uses a non-Latin script.

Build your IPS on Nomedic. A structured digital record accessible on your phone removes language barriers at foreign pharmacies and hepatology clinics.

Check your destination's import rules. Verify the personal-use import limit (quantity and documentation requirements) for your specific medication at least six weeks before travel.

Review your insurance policy. Confirm whether viral rebound or acute hepatic events triggered by a supply interruption are covered, and whether the policy requires pre-authorisation for hepatology consultations abroad.

Frequently asked questions

Can I buy DAAs over the counter abroad without a prescription?

In most countries, direct-acting antivirals require a local prescription even if they are available as generics. India and Egypt are exceptions where pharmacy dispensing norms are looser, but a valid diagnosis document still speeds the process and reduces counterfeit risk.

What happens to my hepatitis B treatment if I miss doses while travelling?

Missed doses of tenofovir or entecavir can cause viral rebound, which in turn raises the risk of hepatic flare. Even a short gap is clinically significant. Carry a buffer supply and identify a hepatology clinic at your destination before you depart.

Does EHIC cover hepatitis C treatment in Europe?

EHIC and GHIC provide access to state-provided healthcare on the same terms as residents. For an established hepatitis C regimen, most EU systems treat this as necessary ongoing treatment, but dispensing rules vary by country and upfront pharmacy costs may apply.

Is generic sofosbuvir the same as the branded version?

Approved generic sofosbuvir from manufacturers such as Cipla or Mylan contains the same active molecule and must meet bioequivalence standards set by the national regulator. Verify the manufacturer holds approval from the country's medicines authority before purchasing.

How long a supply can I bring across most international borders?

Most countries allow a personal-use import of up to 90 days of prescription medication. Some countries, including Japan, require advance notification or a permit for any quantity. Check your specific destination's rules at least six weeks before travel.

What documents should I carry to get antivirals refilled abroad?

Bring the original pharmacy-labelled packaging, a physician letter with your ICD-10 diagnosis code and current regimen, your most recent viral load result, and a structured digital health record such as an IPS. These four items resolve most dispensing barriers at foreign pharmacies and clinics.