PSYCHIATRIC AND NEUROLOGIC COMORBIDITIES AND HEALTHCARE COSTS IN AUTISM SPECTRUM DISORDER: A NATIONWIDE CLAIMS-BASED STUDY IN SOUTH KOREA
Author(s)
Jeong-Hyeon Park, PharmD1, Seong-Jung Kim, PharmD1, Dong-Won Kang, PhD2, EUI-KYUNG LEE, RPh, PhD1.
1School of Pharmacy, Sungkyunkwan University, Suwon, Korea, Republic of, 2College of Pharmacy, Ajou University, Suwon, Korea, Republic of.
1School of Pharmacy, Sungkyunkwan University, Suwon, Korea, Republic of, 2College of Pharmacy, Ajou University, Suwon, Korea, Republic of.
OBJECTIVES: Psychiatric and neurologic comorbidities are common among individuals with autism spectrum disorder (ASD), yet their distribution and related healthcare costs remain unclear in South Korea. We examined these comorbidities and 1-year healthcare costs using nationwide claims data.
METHODS: We conducted a retrospective cohort study using Korean National Health Insurance Service (NHIS) claims data from 2010 to 2022. Individuals with ASD were identified by at least 2 outpatient claims or at least 1 inpatient claim with ICD-10 codes F84.0, F84.1, F84.5, F84.8, or F84.9, and followed from their first ASD-related visit. Comorbidities included attention-deficit/hyperactivity disorder (ADHD), intellectual disability, behavioral disorders, depression, anxiety, obsessive-compulsive disorder, sleep disorders, and epilepsy. One-year healthcare costs after the first ASD-related visit included direct medical costs only. Cost ratios (CRs) associated with the presence, number, and type of comorbidities were estimated using gamma log-link generalized linear models, adjusted for sociodemographic characteristics.
RESULTS: Among 56,462 individuals with ASD, 23,502 (41.6%) had at least 1 psychiatric or neurologic comorbidity. ADHD was most common (15.8%), followed by intellectual disability (13.5%), depression (7.6%), and epilepsy (6.0%). Mean 1-year healthcare costs were higher with comorbidity than without comorbidity (US$2,029 vs US$1,591). Comorbidity presence was associated with higher costs (adjusted CR, 1.30; 95% CI, 1.28-1.33). Adjusted CRs increased with the number of comorbidities, ranging from 1.21 (95% CI, 1.19-1.24) for 1 comorbidity to 1.89 (95% CI, 1.77-2.03) for 3 or more comorbidities compared with none. Epilepsy was associated with the highest healthcare cost (adjusted CR, 2.36; 95% CI, 2.28-2.45).
CONCLUSIONS: Psychiatric and neurologic comorbidities were associated with higher healthcare costs, especially with multiple comorbidities. ADHD was the most common comorbidity, whereas epilepsy was associated with the greatest cost burden. These findings may provide foundational evidence to inform the management of comorbid conditions in individuals with ASD.
METHODS: We conducted a retrospective cohort study using Korean National Health Insurance Service (NHIS) claims data from 2010 to 2022. Individuals with ASD were identified by at least 2 outpatient claims or at least 1 inpatient claim with ICD-10 codes F84.0, F84.1, F84.5, F84.8, or F84.9, and followed from their first ASD-related visit. Comorbidities included attention-deficit/hyperactivity disorder (ADHD), intellectual disability, behavioral disorders, depression, anxiety, obsessive-compulsive disorder, sleep disorders, and epilepsy. One-year healthcare costs after the first ASD-related visit included direct medical costs only. Cost ratios (CRs) associated with the presence, number, and type of comorbidities were estimated using gamma log-link generalized linear models, adjusted for sociodemographic characteristics.
RESULTS: Among 56,462 individuals with ASD, 23,502 (41.6%) had at least 1 psychiatric or neurologic comorbidity. ADHD was most common (15.8%), followed by intellectual disability (13.5%), depression (7.6%), and epilepsy (6.0%). Mean 1-year healthcare costs were higher with comorbidity than without comorbidity (US$2,029 vs US$1,591). Comorbidity presence was associated with higher costs (adjusted CR, 1.30; 95% CI, 1.28-1.33). Adjusted CRs increased with the number of comorbidities, ranging from 1.21 (95% CI, 1.19-1.24) for 1 comorbidity to 1.89 (95% CI, 1.77-2.03) for 3 or more comorbidities compared with none. Epilepsy was associated with the highest healthcare cost (adjusted CR, 2.36; 95% CI, 2.28-2.45).
CONCLUSIONS: Psychiatric and neurologic comorbidities were associated with higher healthcare costs, especially with multiple comorbidities. ADHD was the most common comorbidity, whereas epilepsy was associated with the greatest cost burden. These findings may provide foundational evidence to inform the management of comorbid conditions in individuals with ASD.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD13
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Mental Health (including addiction), No Additional Disease & Conditions/Specialized Treatment Areas