Economic and clinical burden of nonalcoholic steatohepatitis in patients with type 2 diabetes in the US

Diabetes Care Jan 11, 2020

Younossi ZM, Tampi RP, Racila A, et al. - Experts designed a Markov model with 1-year cycles and 20-year horizon to investigate the economic burden of nonalcoholic steatohepatitis (NASH) with T2DM individuals in the US. They distinguished cohort size by population size, prevalence of T2DM, and frequency and incidence of NASH in 2017. In this model, 10 health states—NAFL, NASH fibrosis stages F0 through F3, compensated and decompensated cirrhosis, hepatocellular carcinoma, 1 year post–liver transplant, and post–liver transplant—as well as liver-related, cardiovascular, and background mortality were selected. They computed transition probabilities from meta-analyses and literature. It was calculated that 18.2 million T2DM and nonalcoholic fatty liver disease individuals were living in the US, of which 6.4 million had NASH. Over the next 20 years, this model assumes beneficial clinical and economic burden due to NASH with T2DM. This burden can be higher since they predicted conservative inputs for their model and did not elevate costs or the incidence of T2DM over time. It can be considered that, in NASH individuals, interventions decreasing morbidity and mortality with T2DM could potentially decrease this projected clinical and economic burden.
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