Epidemiologic features and economic burden of Wilson's disease in South Korea: a nationwide analysis of the entire patient population

Abstract

Wilson's disease (WD) is a rare genetic disorder causing copper accumulation in the liver, brain, and other organs, causing severe health complications. While studies have assessed WD's economic impact, research on the financial burden of its complications remains limited. This study examines both the epidemiological characteristics and socioeconomic burden of WD by complication type using an all-cause cost-of-illness approach with 2019 claims data from the National Health Insurance Service of South Korea (NHIS). Among 1462 patients (prevalence: 0.028 per 1,000), complications were present in 68.7%, with hepatic (55.8%) being most common, followed by neurological (16.8%), psychiatric (13.9%), and hematological (6.8%). Disabilities affected 21.5% of patients, with 54.5% classified as severe. Annual hospitalization rates were 6.44% for WD-related and 19.36% for all-cause admissions, with WD-related hospitalizations averaging 4.38 per patient. Medication adherence was low (53.4% mean medication possession ratio). The societal perspective, the all-cause per-capita cost was $6297, totaling $9.21 million nationally. Neurological complications increased costs by 1.84 times, psychiatric by 1.64, and disabilities by 1.66. WD imposes a substantial socioeconomic burden in South Korea, primarily due to neurological and psychiatric complications and high hospitalization rates. Targeted prevention and effective management of these complications are essential to reduce costs and improve outcomes.