Nonalcoholic steatohepatitis (NASH) is the progressive form of nonalcoholic fatty liver disease. Our aim was to estimate the total economic burden of NASH and advanced NASH in the United States. We constructed lifetime Markov models for all stages of NASH and a separate model to specifically identify the increased burden of advanced NASH (fibrosis stage >3). The models comprised patients aged 18+, who moved through seven different health states. We used a lifetime horizon with 1-year cycles for each transition. Cohort size was estimated using US population data, and prevalence and incidence rates were obtained from the literature. Transition probabilities between states were derived from meta-analyses. Costs included inpatient, outpatient, professional services, emergency department, and drug costs, which were obtained from the Center for Medicare and Medicaid Services Fee Schedule 2017 and published data. All future costs were discounted at an annual rate of 3%. Our models estimated that there are 6.65 million adults (18+ years old) with NASH in the United States and that there were 232,000 incident cases in 2017. Lifetime costs of all NASH patients in the United States in 2017 will be $222.6 billion, and the cost of the advanced NASH population will be $95.4 billion. Conclusion: NASH, especially advanced NASH, is associated with high lifetime economic burden; in the absence of treatment, the total direct costs of illness for these patients will continue to grow, and these costs would be even greater if the societal costs are included.
Nonalcoholic steatohepatitis (NASH) is the progressive form of nonalcoholic fatty liver disease. Our aim was to estimate the total economic burden of NASH and advanced NASH in the United States. We constructed lifetime Markov models for all stages of NASH and a separate model to specifically identify the increased burden of advanced NASH (fibrosis stage >3). The models comprised patients aged 18+, who moved through seven different health states. We used a lifetime horizon with 1-year cycles for each transition. Cohort size was estimated using US population data, and prevalence and incidence rates were obtained from the literature. Transition probabilities between states were derived from meta-analyses. Costs included inpatient, outpatient, professional services, emergency department, and drug costs, which were obtained from the Center for Medicare and Medicaid Services Fee Schedule 2017 and published data. All future costs were discounted at an annual rate of 3%. Our models estimated that there are 6.65 million adults (18+ years old) with NASH in the United States and that there were 232,000 incident cases in 2017. Lifetime costs of all NASH patients in the United States in 2017 will be $222.6 billion, and the cost of the advanced NASH population will be $95.4 billion. Conclusion: NASH, especially advanced NASH, is associated with high lifetime economic burden; in the absence of treatment, the total direct costs of illness for these patients will continue to grow, and these costs would be even greater if the societal costs are included.
Authors: Jörn M Schattenberg; Jeffrey V Lazarus; Philip N Newsome; Lawrence Serfaty; Alessio Aghemo; Salvador Augustin; Emmanuel Tsochatzis; Victor de Ledinghen; Elisabetta Bugianesi; Manuel Romero-Gomez; Heike Bantel; Stephen D Ryder; Jerome Boursier; Vincent Leroy; Javier Crespo; Laurent Castera; Lefteris Floros; Vincenzo Atella; Jorge Mestre-Ferrandiz; Rachel Elliott; Achim Kautz; Alice Morgan; Sally Hartmanis; Sharad Vasudevan; Lynne Pezzullo; Aldo Trylesinski; Sandrine Cure; Victoria Higgins; Vlad Ratziu Journal: Liver Int Date: 2021-03-18 Impact factor: 5.828
Authors: Naeimeh Atabaki-Pasdar; Mattias Ohlsson; Ana Viñuela; Francesca Frau; Hugo Pomares-Millan; Mark Haid; Angus G Jones; E Louise Thomas; Robert W Koivula; Azra Kurbasic; Pascal M Mutie; Hugo Fitipaldi; Juan Fernandez; Adem Y Dawed; Giuseppe N Giordano; Ian M Forgie; Timothy J McDonald; Femke Rutters; Henna Cederberg; Elizaveta Chabanova; Matilda Dale; Federico De Masi; Cecilia Engel Thomas; Kristine H Allin; Tue H Hansen; Alison Heggie; Mun-Gwan Hong; Petra J M Elders; Gwen Kennedy; Tarja Kokkola; Helle Krogh Pedersen; Anubha Mahajan; Donna McEvoy; Francois Pattou; Violeta Raverdy; Ragna S Häussler; Sapna Sharma; Henrik S Thomsen; Jagadish Vangipurapu; Henrik Vestergaard; Leen M 't Hart; Jerzy Adamski; Petra B Musholt; Soren Brage; Søren Brunak; Emmanouil Dermitzakis; Gary Frost; Torben Hansen; Markku Laakso; Oluf Pedersen; Martin Ridderstråle; Hartmut Ruetten; Andrew T Hattersley; Mark Walker; Joline W J Beulens; Andrea Mari; Jochen M Schwenk; Ramneek Gupta; Mark I McCarthy; Ewan R Pearson; Jimmy D Bell; Imre Pavo; Paul W Franks Journal: PLoS Med Date: 2020-06-19 Impact factor: 11.069