Severe Cost Burden Associated with Chronic Pancreatitis

A new analysis of cohort study data estimates the average annual cost of caring for children with chronic pancreatitis or acute recurrent pancreatitis in the US now approaches $50,000.

Investigators tallied healthcare utilization rates by 224 children (median age: 12.7 years) who participated in the INSPIRE registry (International Study Group of Pediatric Pancreatitis: In search for a cuRE). They then pulled data on average costs across the US for each product and service to estimate the cost of treating each patient in this country.

The majority of the children (58%) had acute recurrent pancreatitis. The remaining 42% had chronic pancreatitis.

The mean number of hospitalizations, including hospitalizations for surgery and endoscopic retrograde cholangiopancreatography (ERCP), was 2.3 per patient per year. The estimated average cost for those hospitalizations was $38,755 per patient per year — a figure that rose to $40,589 per patient per year when investigators included the estimated cost of outpatient medications.

The costs associated with each regular surgery, including the hospital stay, were $42,951 per patient per surgery. The costs associated with each ERCP were far lower: $12,035 per procedure.

The investigators also looked at the cost of routine care and estimated that the annual per patient cost of pancreatic enzyme replacement therapy was $4,114, while the annual per patient cost of diabetic medications was $1,761 and the annual cost of pain medications was $614.

An exploratory analysis found a number of characteristics that appeared to be associated with higher costs: more frequent attacks of acute recurrent pancreatitis, reported constant or episodic pain, family history of pancreatic cancer, and use of pain medication.

“The severe burden of disease associated with these conditions and their chronicity results in high healthcare utilization and costs,” the study authors wrote in the Journal of Pediatric Gastroenterology and Nutrition. “Interventions that reduce the need for hospitalization could lower costs for these children and their families.”

The findings of the new study suggest that the cost of pancreatitis care has increased dramatically in recent years.

A 2007 paper published in Pancreas estimated that the mean cost per hospitalization in cases of acute pancreatitis was $9,870 (95% confidence interval [CI], $9,300 to $10,400). Had that number increased no faster than the rate of inflation, it would have been about $12,100 by 2015.

The 2007 study tried to take a comprehensive look at the cost of pancreatitis hospitalizations across the country. Investigators searched the 2003 Healthcare Cost and Utilization Project-National Inpatient Sample for hospitalization discharge codes that indicated pancreatitis. Then, they tallied costs and analyzed the data with regard patient demographics and hospitalization rates.

The estimated total cost for pancreatitis admissions across the country was $2.2 billion. Costs per hospitalization, they found, were higher in urban hospitals, teaching hospitals, and for patients older than 65 years. The hospitalization rate was 0.52 per 1,000 (95% CI, 0.48-0.56) for whites and 0.76 per 1,000 (95% CI, 0.65-0.87) for blacks.

Although the methods of the earlier study were different than those of the newer study, its conclusions were similar.

“This study highlights the need for prevention efforts, particularly targeting high-risk groups, and for further studies to identify cost effective treatment strategies for acute pancreatitis,” its authors wrote.