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Health Costs Triple When Nonalcoholic Steatohepatitis Progresses to Cirrhosis

Monthly health care costs more than triple after patients with nonalcoholic fatty liver disease (NAFLD) and its more advanced form, nonalcoholic steatohepatitis (NASH), receive a diagnosis of cirrhosis, according to a study presented during a poster session at ISPOR 2019. 

“Identifying patients with NAFLD/NASH at risk of disease progression is necessary,” wrote researchers from Bristol-Myers Squibb. “Effective therapies that halt or reverse disease progression may potentially improve morbidity and decrease costs.” 

The study used commercial and Medicare databases to identify 68,122 patients in the United States with NAFLD/NASH and their health care use and costs 12 months before and after a diagnosis of cirrhosis. 

After a cirrhosis diagnosis, per-patient-per-month total all-cause health care costs rose significantly, from $2555 to $8525, researchers found. Per-patient-per-month costs jumped from $3313 to $11,513 for patients with decompensated cirrhosis compared with $1335 to $3711 for patients with compensated cirrhosis. Patients with type 2 diabetes diagnosed with cirrhosis had monthly costs increase f rom $2894 to $9038, compared with $2245 to $8056 for patients without type 2 diabetes. 

The study identified corresponding increases in monthly inpatient, outpatient, and emergency department care. 

Inpatient costs in the study population comprised 43% of total costs before cirrhosis diagnosis, according to the poster abstract. After diagnosis, their share increased to 62%. —Jolynn Tumolo 

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