Alice Morgan1, Sally Hartmanis2, Emmanuel Tsochatzis3, Philip N Newsome4,5,6, Stephen D Ryder7, Rachel Elliott8, Lefteris Floros9, Richard Hall10, Victoria Higgins11, George Stanley12, Sandrine Cure12, Sharad Vasudevan2, Lynne Pezzullo13. 1. Deloitte, Canberra, Australia. alicemorgan@deloitte.com.au. 2. Deloitte, Victoria, Australia. 3. UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK. 4. National Institute for Health Research Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham, Birmingham, UK. 5. Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherpay, University of Birmingham, Birmingham, UK. 6. Liver Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. 7. National Institute for Health Research Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK. 8. University of Manchester, Manchester, UK. 9. PHMR Limited, London, UK. 10. Liver4Life, Bournemouth, United Kingdom. 11. Adelphi Real World, Cheshire, United Kingdom. 12. Intercept Pharmaceuticals, London, United Kingdom. 13. Deloitte, Canberra, Australia.
Abstract
BACKGROUND AND AIMS: Non-alcoholic steatohepatitis (NASH) - a progressive subset of non-alcoholic fatty liver disease (NAFLD) - is a chronic liver disease that can progress to advanced fibrosis, cirrhosis, and end-stage liver disease (ESLD) if left untreated. Early-stage NASH is usually asymptomatic, meaning a large proportion of the prevalent population are undiagnosed. Receiving a NASH diagnosis increases the probability that a patient will receive interventions for the purpose of managing their condition. The purpose of this study was to estimate the disease burden and economic impact of diagnosed NASH in the United Kingdom (UK) adult population in 2018. METHODS: The socioeconomic burden of diagnosed NASH from a societal perspective was estimated using cost-of-illness methodology applying a prevalence approach. This involved estimating the number of adults with diagnosed NASH in the UK in a base period (2018) and the economic and wellbeing costs attributable to diagnosed NASH in that period. The analysis was based on a targeted review of the scientific literature, existing databases and consultation with clinical experts, health economists and patient groups. RESULTS: Of the prevalent NASH population in the UK in 2018, an estimated 79.8% were not diagnosed. In particular, of the prevalent population in disease stages F0 to F2, only 2.0% (F0), 2.0% (F1) and 16.5% (F2), respectively, were diagnosed. Total economic costs of diagnosed NASH in the UK ranged from £2.3 billion (lower prevalence scenario, base probability of diagnosis scenario) to £4.2 billion (higher prevalence scenario, base probability of diagnosis scenario). In 2018, people with NASH in the UK were estimated to experience 94,094 to 174,564 disability-adjusted life years (DALYs) overall. Total wellbeing costs associated with NASH in 2018 were estimated to range between £5.6 to £10.5 billion. CONCLUSION: The prevention and appropriate management of adult NASH patients could result in reduced economic costs and improvements in wellbeing.
BACKGROUND AND AIMS: Non-alcoholic steatohepatitis (NASH) - a progressive subset of non-alcoholic fatty liver disease (NAFLD) - is a chronic liver disease that can progress to advanced fibrosis, cirrhosis, and end-stage liver disease (ESLD) if left untreated. Early-stage NASH is usually asymptomatic, meaning a large proportion of the prevalent population are undiagnosed. Receiving a NASH diagnosis increases the probability that a patient will receive interventions for the purpose of managing their condition. The purpose of this study was to estimate the disease burden and economic impact of diagnosed NASH in the United Kingdom (UK) adult population in 2018. METHODS: The socioeconomic burden of diagnosed NASH from a societal perspective was estimated using cost-of-illness methodology applying a prevalence approach. This involved estimating the number of adults with diagnosed NASH in the UK in a base period (2018) and the economic and wellbeing costs attributable to diagnosed NASH in that period. The analysis was based on a targeted review of the scientific literature, existing databases and consultation with clinical experts, health economists and patient groups. RESULTS: Of the prevalent NASH population in the UK in 2018, an estimated 79.8% were not diagnosed. In particular, of the prevalent population in disease stages F0 to F2, only 2.0% (F0), 2.0% (F1) and 16.5% (F2), respectively, were diagnosed. Total economic costs of diagnosed NASH in the UK ranged from £2.3 billion (lower prevalence scenario, base probability of diagnosis scenario) to £4.2 billion (higher prevalence scenario, base probability of diagnosis scenario). In 2018, people with NASH in the UK were estimated to experience 94,094 to 174,564 disability-adjusted life years (DALYs) overall. Total wellbeing costs associated with NASH in 2018 were estimated to range between £5.6 to £10.5 billion. CONCLUSION: The prevention and appropriate management of adult NASH patients could result in reduced economic costs and improvements in wellbeing.
Entities:
Keywords:
Burden of disease; Cost-of-illness analysis; Economic impact; Health care resource utilisation; Non-alcoholic steatohepatitis (NASH)
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