Burden of Cirrhosis on Patients and Caregivers

Burden of Cirrhosis on SocietyCirrhosis is the final common pathway for most chronic liver diseases, affecting approximately 0.27% of the adult population and accounting for over 60,000 deaths in the United States each year.(1,2) Although the general public perceives liver disease to be rare, cirrhosis-attributable mortality surpasses that from diabetes or kidney disease.(2,3) Cirrhosis is a very resource-intensive condition.In the United States, more than half a million cirrhosis hospitalizations occur each year, at a rate that is rising much faster than other chronic illnesses.(4) Nearly 70% of patients with cirrhosis survive their hospitalization experience readmission, at a cost of over $20,000 each time.(5) In 2015, the total cost of medical care for patients with cirrhosis in the employer-sponsored insurance population was more than $9.5 billion.(6) Because employer-based insurance covers approximately half of the US population, the medical costs for all patients with cirrhosis in the United States likely approximates the $21 billion spent on congestive heart failure.(7) Finally, the national and global prevalence appears to be increasing, driven by an aging population as well as a rise in alcoholic and nonalcoholic fatty liver disease.(8) At the population level, the prevalence of cirrhosis is highest among blacks and those with lower levels of education and income.(1) These disparities indicate that cirrhosis burden is experienced disproportionately by already disadvantaged groups.