Disability-Associated Economic Burden Among Patients With Wilson’s Disease in South Korea: A Nationwide Cost-of-Illness Study
Author(s)
Dong Eun Im, BA, Hye-Young Kang, PhD.
Yonsei University, College of Pharmacy, Incheon, Korea, Republic of.
Yonsei University, College of Pharmacy, Incheon, Korea, Republic of.
OBJECTIVES: Wilson’s disease (WD) is a rare genetic disorder that causes progressive hepatic and neurological damage, often leading to disability. While the burden of WD has been explored, limited evidence exists regarding the differential economic burden among patients with disabilities. This study aimed to quantify and compare the healthcare utilization and societal costs of WD patients by disability status in South Korea.
METHODS: We conducted a cross-sectional analysis using 2019 customized claims data from the National Health Insurance Service (NHIS), encompassing all patients with a confirmed diagnosis of WD (ICD-10: E83.0) and Special Government Subsidy (SGS) registration for rare diseases (V119). Patients were stratified by disability registration. Descriptive statistics were used to compare demographic, clinical, and cost characteristics. Direct medical costs, non-medical costs (e.g., caregiver and transport), and productivity loss were estimated from a societal perspective in 2019 US dollars (USD).
RESULTS: Among 1,462 WD patients in the nation, 21.5% (n=314) had a registered disability. Disabled patients were more likely to be in the low income group (45.5% vs. 23.4%) and enrolled in public subsidized Medical Aid program (19.7% vs. 2.6%) compared to non-disabled WD patients. Annual hospitalization rates were significantly higher in the disabled group (33.4% vs. 15.5%, p<0.0001), with more inpatient days (8.5 vs. 5.8 days, p<0.0001) and outpatient visits (26.0 vs. 17.1 visits/year, p=0.0006). From a societal perspective, per-capita all-causes annual costs were 2.85 times higher for disabled than non-disabled WD patients ($12,831 vs. $4,510). The largest cost gaps were observed in inpatient-related productivity losses (9.76-fold), caregiver costs (8.43-fold), and inpatient services (7.06-fold).
CONCLUSIONS: Disability among WD patients is associated with significant socioeconomic vulnerability and disproportionate healthcare costs. These findings highlight the need for targeted care coordination and support strategies to mitigate the disease burden in high-risk subgroups.
METHODS: We conducted a cross-sectional analysis using 2019 customized claims data from the National Health Insurance Service (NHIS), encompassing all patients with a confirmed diagnosis of WD (ICD-10: E83.0) and Special Government Subsidy (SGS) registration for rare diseases (V119). Patients were stratified by disability registration. Descriptive statistics were used to compare demographic, clinical, and cost characteristics. Direct medical costs, non-medical costs (e.g., caregiver and transport), and productivity loss were estimated from a societal perspective in 2019 US dollars (USD).
RESULTS: Among 1,462 WD patients in the nation, 21.5% (n=314) had a registered disability. Disabled patients were more likely to be in the low income group (45.5% vs. 23.4%) and enrolled in public subsidized Medical Aid program (19.7% vs. 2.6%) compared to non-disabled WD patients. Annual hospitalization rates were significantly higher in the disabled group (33.4% vs. 15.5%, p<0.0001), with more inpatient days (8.5 vs. 5.8 days, p<0.0001) and outpatient visits (26.0 vs. 17.1 visits/year, p=0.0006). From a societal perspective, per-capita all-causes annual costs were 2.85 times higher for disabled than non-disabled WD patients ($12,831 vs. $4,510). The largest cost gaps were observed in inpatient-related productivity losses (9.76-fold), caregiver costs (8.43-fold), and inpatient services (7.06-fold).
CONCLUSIONS: Disability among WD patients is associated with significant socioeconomic vulnerability and disproportionate healthcare costs. These findings highlight the need for targeted care coordination and support strategies to mitigate the disease burden in high-risk subgroups.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE335
Topic
Economic Evaluation
Disease
Rare & Orphan Diseases, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)