Burden of illness for patients with primary biliary cholangitis: an observational study of clinical characteristics and healthcare resource utilization.
| Title: | Burden of illness for patients with primary biliary cholangitis: an observational study of clinical characteristics and healthcare resource utilization. |
|---|---|
| Authors: | Gish RG; Robert G Gish Consultants, LLC, San Diego, CA 92037, USA.; MacEwan JP; Genesis Research Group, Hoboken, NJ 07030, USA.; Levine A; Genesis Research Group, Hoboken, NJ 07030, USA.; Lebovitch D; Genesis Research Group, Hoboken, NJ 07030, USA.; Bessonova L; Intercept Pharmaceuticals, Morristown, NJ 07960, USA.; Wheeler D; Intercept Pharmaceuticals, Morristown, NJ 07960, USA.; Nair R; Intercept Pharmaceuticals, Morristown, NJ 07960, USA.; Bonder A; Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA. |
| Source: | Journal of comparative effectiveness research [J Comp Eff Res] 2025 Apr; Vol. 14 (4), pp. e240174. Date of Electronic Publication: 2025 Mar 06. |
| Publication Type: | Journal Article; Observational Study |
| Language: | English |
| Journal Info: | Publisher: Becaris Publishing Country of Publication: England NLM ID: 101577308 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2042-6313 (Electronic) Linking ISSN: 20426305 NLM ISO Abbreviation: J Comp Eff Res Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2023- : Royston, UK : Becaris Publishing; Original Publication: London : Future Medicine |
| MeSH Terms: | Liver Cirrhosis, Biliary*/economics ; Liver Cirrhosis, Biliary*/therapy ; Patient Acceptance of Health Care*/statistics & numerical data ; Cost of Illness*; Hospitalization/statistics & numerical data ; Hospitalization/economics ; Emergency Service, Hospital/statistics & numerical data ; Emergency Service, Hospital/economics ; Medicare/statistics & numerical data ; Medicare/economics ; Medicaid/statistics & numerical data ; Medicaid/economics ; Health Care Costs/statistics & numerical data ; Health Resources/statistics & numerical data ; Health Resources/economics ; Liver Cirrhosis/economics ; Humans ; Male ; Female ; Middle Aged ; Retrospective Studies ; Aged ; United States ; Adult |
| Abstract: | Aim: To evaluate the clinical characteristics and healthcare resource utilization for acute care and its costs for patients with primary biliary cholangitis (PBC) with or without cirrhosis. Materials & methods: This retrospective observational cohort study was conducted using two datasets (Komodo's Healthcare Map™ [Komodo Health] and Optum Clinformatics® Data Mart [CDM] database) between 2015 and 2023. Patients (≥18 years) with PBC were identified based on ≥1 inpatient or ≥2 outpatient claims. Healthcare resource utilization for acute care (hospitalizations and emergency department [ED] visits [not leading to hospitalization]) were assessed in both datasets, and associated medical costs were evaluated in Optum CDM. Results: In Komodo Health, of the 29,758 patients with PBC (mean age: 59.2 years), 21.6% had cirrhosis and 50.4% of patients with cirrhosis had Medicaid or Medicare coverage. Of the total 8143 patients in Optum CDM (mean age: 67.0 years), 20.7% had cirrhosis, and most were enrolled in Medicare (69.7%). There was a larger proportion of men in the cirrhosis group compared with the no-cirrhosis group in Komodo Health (31.7 vs 16.3%) and Optum CDM (29.7 vs 16.5%). Annually, among patients with cirrhosis who had a hospitalization, 69.3% had additional hospitalizations, and among patients who had an ED visit, 52.9% had additional ED visits in Komodo Health; similar results were observed in Optum CDM. Among patients with at least one acute-care event, the mean annual acute-care costs with and without cirrhosis were $113,568 and $47,436, respectively. Conclusion: Data from two large healthcare claims databases showed that the majority of patients who had at least one acute-care event experienced additional acute-care events, particularly among those with cirrhosis. Timely treatment to avoid hospitalization and disease progression may help mitigate the clinical and economic burden for patients with PBC. |
| References: | Hepatology. 2019 Jan;69(1):394-419. (PMID: 30070375); Appl Clin Inform. 2022 Aug;13(4):865-873. (PMID: 35896508); J Manag Care Spec Pharm. 2016 Oct;22(10-a-s Suppl):S3-S15. (PMID: 27700211); Pharmacoepidemiol Drug Saf. 2024 Oct;33(10):e70013. (PMID: 39415072); Am Health Drug Benefits. 2019 Jun-Jul;12(4):188-197. (PMID: 31428236); Clin Gastroenterol Hepatol. 2018 Aug;16(8):1342-1350.e1. (PMID: 29277621); BMJ. 2018 Jul 18;362:k2817. (PMID: 30021785); Hepatol Commun. 2019 Jan 28;3(3):356-364. (PMID: 30859148); Inquiry. 2019 Jan-Dec;56:46958019838118. (PMID: 30947608); J Clin Gastroenterol. 2013 May-Jun;47(5):e50-4. (PMID: 23090041); Dig Dis Sci. 2020 Feb;65(2):406-415. (PMID: 31489564); J Clin Gastroenterol. 2019 Oct;53(9):693-698. (PMID: 30148766); Hepatol Commun. 2023 Jun 2;7(6):. (PMID: 37267215); Am J Gastroenterol. 2019 Jan;114(1):48-63. (PMID: 30429590); Dig Dis Sci. 2021 May;66(5):1461-1476. (PMID: 32535779); Can J Gastroenterol. 2010 Mar;24(3):175-82. (PMID: 20352146); Hepatology. 2021 Aug;74(2):879-891. (PMID: 33636012); Hepatology. 2019 Jan;69(1):237-244. (PMID: 30015376) |
| Contributed Indexing: | Keywords: acute care; healthcare resource utilization; liver cirrhosis; primary biliary cholangitis |
| Entry Date(s): | Date Created: 20250306 Date Completed: 20250321 Latest Revision: 20250528 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11963345 |
| DOI: | 10.57264/cer-2024-0174 |
| PMID: | 40047576 |
| Database: | MEDLINE |
Journal Article; Observational Study