Table 1.
Economic costs associated with hepatic encephalopathy
| Study; country; perspective | Population | Outcome(s) | Cost(s) |
|---|---|---|---|
| Irish et al. [32]; USA; payer perspective | Pts with HE-related hospitalization in 2012; Medicare claims database (n = 1113) | Mean no. of hospitalizations: 2.4 Mean duration of hospitalization: 5.9 days Mean no. of outpatient visits: 11.0 |
Mean hospitalization costs: $US25,364–58,625 |
| Poovorawan et al. [27]; Thailand; payer perspective | Pts with cirrhosis (ICD-10 code K74)-related hospitalization in 2010 (n = 92,301 admissions) Pts with HE (n = 5292) |
Mean ± SD duration of HE-related hospitalization: 9.1 ± 10.9 days Mortality during hospitalization: 32% |
Mean ± SD hospitalization costs: THB44,606 ± 71,001; $US1394 ± 2219 Total healthcare costs: THB58,134 ± 79,763; $US1817 ± 2493 |
| Roggeri et al. [21]; Italy; payer perspective | Pts with ≥ 1 overt HE-related hospitalization between 1 January 2011 and 31 December 2011 (n = 381) | Mortality During index hospitalization (n = 82; 21.5%) During hospitalization at 1-year follow-up (n = 22; 5.8%) Mean ± SD duration of overt HE recurrence-related hospitalization: 9 ± 7 days |
Mean ± SD direct costs of single overt HE recurrence-related hospitalizationa: €3361 ± 1286; $US3838 ± 1469 Total annual costs for pts with (n = 124) and without (n = 172) overt HE recurrence: €21,272 ($US24,293) vs. €12,098 ($US13,816), respectively (p < 0.001) Mean ± SD annual hospitalization cost with recurrence vs. no recurrence: €18,970 ± 16,652 vs. €10,196 ± 22,182 Mean ± SD annual drug cost with recurrence vs. no recurrence: €1633 ± 1807 vs. €1173 ± 1657 Mean ± SD annual diagnostic and therapeutic procedure costs with recurrence vs. no recurrence: €669 ± 974 vs. €729 ± 1519 |
| Benković et al. [28]; Croatia; payer perspective | Pts with malnutrition and HE in 2012 (n = 945) | Total healthcare costs: €1,019,994 Mean healthcare costs/pt: €1344 |
|
| Lee et al. [29]; China; payer perspective | Pts with HE (ICD-9-CM diagnosis code 572.2) associated with benzodiazepine use enrolled in previous (2005–2009) and current (2009–2012) clinical studies at single hospital (n = 322) | Mean ± SD HE-related healthcare costs Hospitalization: NTD6987 ± 419; $US231 ± 14 Outpatient visits: NTD812 ± 99; $US27 ± 3 ER visits: NTD4170 ± 641; $US138 ± 21 Overall medical costs: NTD11,970 ± 210; $US396 ± 7 |
|
| Andersen et al. [30]; Denmark; provider perspective | Pts with cirrhosis with previous HE-related hospitalization receiving outpatient rehabilitation (2009; n = 19) vs. pts not receiving rehabilitation (i.e. control group; 2008; n = 14) | Survival (≤ 20 months from baseline; rehabilitation group vs. control group): 84 vs. 36%, respectively; p = 0.01 | Median (range) costs Rehospitalization at study hospital Rehabilitation group: DKK52,266 (0–409,402); $US9643 (0–75,535) Control group: DKK51,266 (0–410,128); $US9459 (0–75,669) Rehospitalization at any hospital Rehabilitation group: DKK84,730 (0–409,402); $US15,633 (0–75,535) Control group: DKK84,395 (0–471,562); $US15,571 (0–87,004) |
| El Khoury et al. [26]; Brazil, Canada, Asia-pacific region, Europe (systematic review); payer (n = 3 studies) and provider (n = 7 studies) perspective; perspective unknown for 1 study | Pts with HE related to HCV infection Studies published between January 1990 and January 2011 (n = 11 studies) |
Mean (range) global HE-related costs (2010 values): $US13,270 (5370–50,120) | |
| El Khoury et al. [25]; USA (systematic review); provider perspective (n = 5 studies) | Pts with HE associated with HCV infection Studies published between 1997 and 2007 (n = 5) |
Mean HE-related costs (2010 values) Year 1: $US16,430 Year 2: $US3810 |
|
| Stepanova et al. [31]; USA; payer perspective | Pts with HE-related hospitalizations between 2005 and 2009 (n = 111,090) | Mean ± SD duration of HE-related hospitalization 2005: 8 ± 0.2 days 2009: 8.5 ± 0.2 days Mean no. procedures 2005: 1.9 ± 0.1 2009: 2.2 ± 0.1 In-hospital mortality 2005: 15.6% 2009: 14.4% |
Total HE-related hospitalization charges 2005: $US4.677 billion 2009: $US7.254 billion Mean HE-related hospitalization charges 2005: $US 46,663 ± 2180 2009: $US63,107 ± 3244 Mean HE-related costs per pt 2005: $US16,512 ± 709 2009: $US17,812 ± 764 |
DKK Danish krone, ER emergency room, HCV hepatitis C virus, HE hepatic encephalopathy, ICD-9-CM International Classification of Diseases, Ninth Revision, Clinical Modification, ICD-10 ICD, Tenth Revision, mo month, NTD New Taiwan dollars, pt patient, SD standard deviation, THB Thai baht
aExchange rate €1.00 = $US1.1420