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In this insightful discussion, Dr. Tatyana Kushner, hepatologist and associate professor at Weill Cornell Medicine, explores the critical issue of medication adherence in patients living with Primary Biliary Cholangitis (PBC). While ursodeoxycholic acid (ursodiol) remains the cornerstone of first-line therapy for PBC, up to half of patients express uncertainty or reluctance about taking it consistently. Dr. Kushner delves into the complex barriers affecting adherence, including lack of symptom relief, fear of side effects, misunderstanding of long-term benefits, pill burden from multiple daily doses, and socioeconomic challenges such as medication costs and insurance coverage. She also addresses the impact of extrahepatic symptoms—like pruritus, fatigue, and depression—which can further discourage regular medication use. Importantly, certain subgroups, such as younger patients and males, have been shown to be at higher risk for non-adherence and may require additional support. If you're a healthcare provider managing PBC or a patient navigating treatment, this video offers valuable insights into improving adherence and outcomes.