Nonalcoholic steatohepatitis (NASH) progression may have a substantial financial burden with annual costs per person at least 2-fold higher compared to those without progression according to research to be presented at AMCP 2024. 

The costs of care for US patients with NASH, a liver condition characterized by fat buildup, inflammation, damage, fibrosis, and potentially cirrhosis, are significant. While a correlation between NASH disease severity and cost has been established, researchers seek to understand how costs vary depending on the progression of NASH. 

Researchers use Optum’s deidentified Clinformatics Data Mart to examine the differences in annual healthcare costs among NASH patients based on the occurrence, type, and timing of disease progression. The study examined adult patients without baseline cirrhosis who were diagnosed with NASH between October 2015 and December 2022. All patients were tracked until death, loss to follow-up, or the end of the study period. Progression was determined by the development of cirrhosis, decompensated cirrhosis, liver transplant, or hepatocellular carcinoma. Total annual costs per person were compared between those with progression and those without, with adjustments made for baseline factors.

A total of 19,419 patients without cirrhosis, with a mean age of 59.8 years, were followed for an average of 3.2 years. During this time, 4,235 patients experienced progression, mostly due to decompensated cirrhosis events occurring at least one year into follow-up. The annual costs per person were higher for those who experienced progression compared to those who did not, with a significant relative risk of 2.3. The highest costs were seen among patients with hepatocellular carcinoma, followed by liver transplant, decompensated cirrhosis, and cirrhosis. Adjusted annual costs per person significantly increased over time for those with progression, while only significant increases in costs were observed in later years for those without progression. 

“These data show that the burden of care for NASH is substantial, and compared with those without progression, the annual costs per person with progression are at least 2-fold higher, with the gap increasing over time,” said researchers. “Therapies that slow progression may help alleviate the financial burden of managing NASH.”

Reference
Kim Y, QIAN C, Szabo S, et al. Evaluating the cost of care and disease progression among patients with nonalcoholic steatohepatitis (NASH): A US cohort study. J Manag Care Spec Pharm. 2024;30(4-a suppl):S78. AMCP 2024 poster abstract.