Real-World Healthcare Resource Utilization and Related Costs Associated With Cholangiocarcinoma in the Brazilian Private Market

OBJECTIVES: Despite being rare, cholangiocarcinoma (CCA) is the second most common hepatic neoplasm, comprising 10% of liver and 3% of gastrointestinal tumors. It arises in the bile ducts and predominantly affects older adults. Due to unclear symptoms, CCA is often diagnosed at advanced stages, limiting treatment options, resulting in substantial mortality. This study aims to assess the epidemiological data and cost of CCA within a Brazilian private market.

METHODS: Retrospective database study using administrative data from January/2019—December/2023. Adults with malignant neoplasms of the digestive organs (ICD-10 C15-C26) and cholangiocarcinoma diagnoses (ICD-10 C22.1, or C24) were identified. Available data include demographics, comorbidities, healthcare resource utilization, and costs reported for the year and includes inpatient/outpatient visits, surgery, emergency department, and tests. Chi-square and Fisher’s exact and Student’s t tests for categorical/continuous measures were used. Kaplan–Meier curves were used to estimate the cumulative survival rates. Statistical significance for p<0.05.

RESULTS: Of 60,012 beneficiaries, 660 patients had malignant neoplasms of the digestive organs. From this total 3.5% had cholangiocarcinoma (74.6 ± 11.9 years; 73.9% female). From the data, the annual rates of procedures were: 5.6 for visits, 2.4 for emergency room visits, 102.4 for tests, 7.7 for therapies, and 1.6 for hospitalizations. The average length of hospitalization was 12.3 days. Annualized healthcare costs associated with the CCA were U$ 30,516/patient. The mortality rate was 69.6%. During the study period, 43.5% of patients underwent chemotherapy and the average annual cost per patient treated increased five times in 5 years (p<0.001).

CONCLUSIONS: CCA prevalence among elderly Brazilians align with global trends. Despite its rarity, CCA poses a significant economic and health burden due to late-stage diagnosis and limited treatment efficacy. Efforts worldwide are focused on developing more effective therapies. This study emphasizes the urgency of prioritizing treatment strategies to enhance outcomes for CCA patients.