Analysis of hospital incidence and direct medical costs of intrahepatic cholangiocarcinoma in Spain (2000-2018)

ABSTRACT

Introduction

Intrahepatic cholangiocarcinomas (iCCA) are aggressive tumors, often diagnosed in advanced stages and with limited curative treatment options. Their incidence has raised in the past years, increasing their associated economic burden. This study aimed to measure hospital incidence and mortality of iCCA and to evaluate direct medical costs.

Methods

Records of admissions due to iCCA between 1 January 2000 and 31 December 2018 were obtained from a Spanish National discharge database. Hospital incidence and mortality were measured within the hospitalized population and medical costs were assessed for specialized healthcare.

Results

Admission files corresponded to 23,315 patients, with a median age of 73 years (IQR = 17) and 55.9% of males. Cholangiocarcinoma presented a hospital incidence of 6.9 per 10,000 persons in 2018, increasing significantly over the study period. In-hospital mortality was 31.5% in the year 2018 and remained stable over the study period. The mean annual direct medical cost of secondary care was €9417 per patient in the year 2017, and increased significantly between 2000 and 2008, stabilizing after 2009.

Conclusion

The incidence of iCCA in Spain increased over the past years. The medical costs of iCCA per patient stabilized after 2008 but total costs are expected to increase if incidence continues to raise.

KEYWORDS:

• Cholangiocarcinoma
• intrahepatic bile ducts
• incidence
• mortality
• direct medical costs

Author contributions

JD contributed to the investigation by analysing and interpreting the burden associated with cholangiocarcinoma in Spain and was a major contribution in the intellectual content revision. AM analysed the current situation of cholangiocarcinoma in Spain, interpreted the statistical data, and was a major contributor in writing the manuscript. All authors read and approved the final manuscript.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Ethics approval and consent to participate

Ethics committee approval and consent were not required for this study.

Data Availability Statement

The data that support the findings of this study are available from the Spanish Ministry of Health via the Unit of Health Care Information and Statistics (Spanish Institute of Health Information) for researchers who meet the criteria for access to confidential data at https://www.mscbs.gob.es/estadEstudios/sanidadDatos/home.htm

Additional information

Funding

This paper was not funded.