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British Columbia's refusal to pay for a new, but costly, treatment for chronic hepatitis B is mimicking U.S. health care, where only the well-insured or well-to-do can afford life-saving treatment, one of the province's top liver specialists says in a letter to the provincial Health Minister.

About 350 B.C. residents are currently receiving Adefovir dipivoxil, marketed as Hepsera, for free, but those giveaways will come to an end by July. As the province is refusing to pay for the drug, patients will be forced to pay for it themselves, and those who are not wealthy will not be able to continue treatment, Eric Yoshida, head of the gastroenterology division at the University of British Columbia, wrote in a March 12 letter to Health Minister George Abbott.

Many of those patients will not respond to other anti-viral drugs, so if they stop taking Hepsera they will be at risk of cirrhosis, liver cancer and "premature and preventable death," Dr. Yoshida wrote in the letter obtained by The Globe and Mail.

In that letter, Dr. Yoshida said the issue of whether to pay for Hepsera out of the public purse is no longer a technical matter.

"The situation of hepatitis B treatment in the province of British Columbia is no longer a medical issue, it is one of medical ethics and human rights," he wrote.

About 1,000 Canadians are taking Hepsera, and many of those are Chinese-Canadians who contracted the disease at birth from their mothers. The virus can also be passed on through sexual contact and intravenous drug use.

Dr. Yoshida and 13 other health-care professionals with expertise in liver disease signed a petition urging the province to pay for Hepsera. However, that runs counter to the recommendations of the Common Drug Review, a federal agency that issues guidelines on which drugs should be covered by provincial pharmacare programs.

In November, the agency recommended that the drug not be funded; the next month, B.C. followed that advice, with the Health Ministry saying there was "no compelling scientific evidence" that Hepsera had any effect on the rate of disease or death from chronic hepatitis B.

The ministry declined to comment on the letter, other than to confirm that it had received the document. However, Mr. Abbott has said he will consider any new information, and that there are two other drugs that are awaiting decisions by the Common Drug Review that might prove effective for patients who have built up resistance to other anti-viral medications.

In an interview, Dr. Yoshida agreed that the two drugs could be useful -- if the province agrees to pay for them.