Patients diagnosed with primary biliary cholangitis (PBC), particularly those who also develop cirrhosis, face frequent hospital visits and high medical costs, found a study published recently in the Journal of Comparative Effectiveness Research.
Analyzing two large healthcare databases from 2015 to 2023, researchers discovered that among patients who experienced at least one hospitalization or emergency department visit, most had multiple acute-care episodes within the same year. The financial burden was substantial, with annual healthcare costs for patients with cirrhosis exceeding $113,000 — more than double the cost for those without cirrhosis.
“[F]indings suggest that patients with PBC and cirrhosis tended to have a higher comorbidity burden and more acute-care events (hospitalizations and/or ED [emergency department] visits) than those without cirrhosis,” explained the study’s authors. “The findings support the importance of timely treatment to prevent hospitalization and disease progression to mitigate the healthcare burden in patients with PBC.”
This study reviewed data from Komodo Health and Optum Clinformatics® Data Mart (CDM) on healthcare resource utilization and associated expenses. A total of 29,758 patients with PBC were identified in Komodo Health, with 21.6% having cirrhosis, while Optum CDM included 8,143 patients, 20.7% of whom had cirrhosis. Patients with cirrhosis were more likely to be men and to have additional medical conditions. Medicare and Medicaid were the most common forms of insurance coverage, especially among those with cirrhosis.
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Frequent hospitalizations were a defining trend. In the Komodo Health data, 69.3% of patients with cirrhosis who had been hospitalized once experienced additional hospitalizations within a year. Similarly, 52.9% of those who had a visit to an emergency department returned for further emergency care. The Optum CDM dataset reflected comparable findings, highlighting a persistent cycle of acute-care events for patients with PBC.
The length of hospital stays was generally longer for patients with cirrhosis, further driving up costs. Among those with at least one acute-care event, the mean annual acute-care cost was $113,568 for patients with cirrhosis, compared with $47,436 for those without. Overall, patients with cirrhosis faced a significantly greater economic burden, as their medical expenses extended beyond hospital stays to include liver-related and other complex healthcare needs.
These results emphasize the importance of early treatment and disease management strategies to reduce hospital visits and lower medical costs. Without intervention, patients with PBC—especially those with cirrhosis—may experience ongoing health complications that require repeated acute care, worsening both their quality of life and financial stability.
By highlighting the clinical and economic toll of PBC, researchers hope these insights will encourage better treatment approaches, improved healthcare access, and strategies to prevent disease progression. Proactive medical care could help reduce hospitalizations, lower healthcare expenses, and improve overall patient outcomes.
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