Medical Costs Increase Over Time for Primary Biliary Cholangitis Patients: A 20-Year Population-Based Study

Area of Science:

• Hepatology
• Health Economics
• Public Health

Background:

• The economic impact of primary biliary cholangitis (PBC) in Asian populations remains understudied at a population level.
• Understanding the financial burden is crucial for resource allocation and patient support.

Purpose of the Study:

• To investigate the economic burden of primary biliary cholangitis (PBC) in Taiwan.
• To analyze trends in medical costs associated with PBC from 2002 to 2021.

Main Methods:

• Utilized the Taiwan National Health Insurance administrative database to identify PBC patients.
• Calculated medical costs using inpatient and outpatient health service data, adjusting for inflation.
• Analyzed cost variations based on demographics, geographic region, and comorbidities.

Main Results:

• Total, inpatient, and outpatient medical costs for PBC patients significantly increased annually.
• Female patients incurred lower total costs compared to males.
• Higher inpatient costs were observed in southern Taiwan compared to northern regions.
• Hepatic events, non-hepatocellular carcinoma (non-HCC), and diabetes were major cost drivers.
• Age (≥80 years), female sex, and dyslipidemia were independently associated with total costs.

Conclusions:

• Both overall and mean outpatient costs for PBC patients demonstrate an upward trend.
• Targeted interventions for subgroups (elderly, males, southern residents, those with hepatic events or diabetes) are recommended to mitigate costs.
• Development of cost-effective therapies (≤ NTD 20,417/year) could significantly benefit PBC patients in Taiwan.