People with advanced liver fibrosis due to non-alcoholic steatohepatitis (NASH) (fibrosis stages F3 – F4) have a high risk of rapid progression to end-stage liver disease (ESLD). This study estimates the prevalence of NASH and the socioeconomic burden associated with its treatment in the EU5 countries (France, Germany, Italy, Spain and UK) during 2018. The socioeconomic burden of NASH per country was estimated using cost-of-illness methodology applying a prevalence approach to estimate the number of adults with NASH, and the economic and wellbeing costs attributable to diagnosed NASHin a base period (2018). Wellbeing costs were estimated using the WHO burden of disease methodology, which includes societal wellbeing measures e.g. disability-adjusted life years (DALYs). The analysiswasbased on extensive literature review and consultations with clinical experts, health economists and patient groups. Epidemiological data were derived from two modelling studies (upper and lower bound). Resource-use estimates were based on literature and expert opinion. Unit costs were sourced from the literature and local fee schedules. Only a small subset of adults living with anystage NASH were diagnosed due to the low probability of being diagnosed at < F3 stage (where there is usually minimal symptomatology). Of the 0.9 – 2.0 million adults estimated to have advanced liver fibrosis due to NASH, only 37.8 – 39.1% were diagnosed. Direct costs due to NASH were estimated at D 619 – 1,292 million/year; 95% of these costs were incurred from the diagnosis and monitoring of patients with advanced liver fibrosis due to NASH. Adults withNASHexperienced between 311,944 and 660,451 DALYs. Total wellbeing costs ranged from D 41,536 to 90,379 million, primarily driven by the high rate of premature mortality in patients with NASH. Prevention of progression to ESLD and appropriate management of adult NASH patients could result in reduced economic impact and improvements in wellbeing.
The economic cost and health burden of non-alcoholic steatohepatitis in the EU5- countries
Bugianesi E;
2020-01-01
Abstract
People with advanced liver fibrosis due to non-alcoholic steatohepatitis (NASH) (fibrosis stages F3 – F4) have a high risk of rapid progression to end-stage liver disease (ESLD). This study estimates the prevalence of NASH and the socioeconomic burden associated with its treatment in the EU5 countries (France, Germany, Italy, Spain and UK) during 2018. The socioeconomic burden of NASH per country was estimated using cost-of-illness methodology applying a prevalence approach to estimate the number of adults with NASH, and the economic and wellbeing costs attributable to diagnosed NASHin a base period (2018). Wellbeing costs were estimated using the WHO burden of disease methodology, which includes societal wellbeing measures e.g. disability-adjusted life years (DALYs). The analysiswasbased on extensive literature review and consultations with clinical experts, health economists and patient groups. Epidemiological data were derived from two modelling studies (upper and lower bound). Resource-use estimates were based on literature and expert opinion. Unit costs were sourced from the literature and local fee schedules. Only a small subset of adults living with anystage NASH were diagnosed due to the low probability of being diagnosed at < F3 stage (where there is usually minimal symptomatology). Of the 0.9 – 2.0 million adults estimated to have advanced liver fibrosis due to NASH, only 37.8 – 39.1% were diagnosed. Direct costs due to NASH were estimated at D 619 – 1,292 million/year; 95% of these costs were incurred from the diagnosis and monitoring of patients with advanced liver fibrosis due to NASH. Adults withNASHexperienced between 311,944 and 660,451 DALYs. Total wellbeing costs ranged from D 41,536 to 90,379 million, primarily driven by the high rate of premature mortality in patients with NASH. Prevention of progression to ESLD and appropriate management of adult NASH patients could result in reduced economic impact and improvements in wellbeing.
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