OBJECTIVES: Primary biliary cholangitis (PBC) is a chronic, progressive autoimmune liver disease. Although PBC progression rate can be slow, the economic burden can be relatively high. This study evaluated the financial burden of healthcare resource utilization in patients with PBC, especially for acute care.

METHODS: This was a retrospective administrative claims analysis using Optum’s deidentified Clinformatics® Data Mart Database. We identified adult patients (≥18 years) with PBC between January 1, 2016, and November 14, 2023, based on ≥1 inpatient or ≥2 outpatient claims. The date of the first claim with PBC diagnosis was set as the index date. Patients were required to be enrolled in a medical and pharmacy plan for 12 months pre-index and ≥1-day post-index. Descriptive analyses assessed demographics and clinical characteristics pre-index. Acute care, including hospitalizations and emergency department (ED) visits (not leading to hospitalization), and associated total and liver-related (including liver diseases, injury, complications, infections, and pancreatobiliary injury and diseases) medical costs (overall and acute care) were assessed.

RESULTS: The 8143 patients with PBC identified were mostly White (69.4%), female (80.8%), and enrolled in Medicare (69.7%) with a mean (SD) age of 67 (12.7) years. Annually, 19.8% of patients had ≥1 hospitalization; among these patients, 62.4% had additional hospitalizations. Similarly, 19.6% of patients had ≥1 ED visit annually; among those, 50.6% had additional ED visits (median [interquartile range]: 2.02 [1.39, 3.39]). The mean (SD) annual total medical costs per patient, overall and liver-related, were $60,040.72 ($166,770.15) and $36,456.65 ($142,385.39), respectively. For patients with acute-care events, the overall and liver-related mean (SD) acute-care costs (hospitalizations and/or ED visits) were $64,332.63 ($176,322.49) and $67,306.24 ($187,176.49), respectively.

CONCLUSIONS: Patients with PBC with ≥1 episode of acute care tend to have additional acute-care episodes. The high utilization of acute-care services contributes to an increased economic burden for patients with PBC.