Healthcare Utilization and Direct Medical Costs of Hepatocellular Carcinoma Treatment — A German Claims Data Study of 2778 Patients

Abstract

Hepatocellular carcinoma (HCC) is a cancer with rising incidence and economic burden. However, evidence on healthcare resource utilization (HCRU) and associated costs is scarce in Europe. This study aims to determine HCRU and costs of HCC from a German third-party payer's perspective. This longitudinal claims study (BARMER statutory health insurance) included patients with HCC (ICD-10-GM C22.0; 2016–2020). HCRU and costs within 2 years after diagnosis were analyzed descriptively and reported per patient (PP) and per patient per month (PPPM). The cohort included 2778 patients. Mean age was 71.9 years (SD ±9.7); 69% were male. Total cost within 2 years after diagnosis was approximately €105 million, with mean cost PP of €37,970 (SD ±€43,840), primarily due to inpatient stays (67%). Median costs PP were highest for patients receiving liver transplantation (€126,943; interquartile range [IQR]: €104,340–€167,205) and lowest for patients without any tumor-specific therapy (€10,132; IQR: €5875–€19,663). Considering the observation period, costs PPPM were lowest for liver resection (€2434; IQR: €1282–€5425) and thermal ablation (€2349; IQR: €1233–€4316), whereas costs PPPM were highest for patients without tumor-specific HCC treatment (€5984; IQR: €2764–€10,908). Similar patterns were observed in the HCRU assessment. In this German claims data analysis, PP costs and HCRU in patients with HCC were higher among those who underwent liver transplantation and lower among those without tumor-specific treatment. However, after adjustment for follow-up duration, the high costs PP among patients receiving curative-intent treatments were significantly relativized. These findings support structured HCC surveillance to potentially improve clinical and economic outcomes.