Healthcare Utilization and Cost of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in Ontario, Canada: An Observational Study
Author(s)
Keyur Patel, PhD, MD1, Diego Moreno Baca, BSc2, Natalia Konstantelos, PhD3, Ginnie Ng, PhD3, Urja Lathia, MSc2;
1University Health Network, Toronto, ON, Canada, 2Novo Nordisk Canada Inc., Mississauga, ON, Canada, 3IQVIA Solutions Canada Inc., Mississauga, ON, Canada
1University Health Network, Toronto, ON, Canada, 2Novo Nordisk Canada Inc., Mississauga, ON, Canada, 3IQVIA Solutions Canada Inc., Mississauga, ON, Canada
Presentation Documents
OBJECTIVES: Describe the healthcare resource utilization (HCRU) and direct healthcare costs to the public payer of persons with MASLD (PwMASLD) in Ontario, Canada.
METHODS: PwMASLD were identified using administrative data at ICES from January 1, 2013, to December 31, 2021, and followed until December 31, 2022. PwMASLD were categorized into mutually exclusive subgroups: (1) MASLD-only without MASH and cirrhosis, (2) MASH without cirrhosis, (3) MASLD/MASH with cirrhosis. PwMASLD were matched with controls (without MASLD) on age, sex, geography, and income quintile. All-cause HCRU and costs (standardized to 2022 Canadian dollars) were reported descriptively.
RESULTS: In total, 18,202 PwMASLD and 72,770 controls were analyzed. The mean age (±standard deviation) of PwMASLD was 53.4±17.2 years, with 56% being female and 88% residing in urban areas. The MASLD-only, MASH, and cirrhosis subgroups consisted of 12,729 (70%), 2,675 (15%), and 2,798 (15%) PwMASLD, respectively. PwMASLD had 2.7-fold the HCRU of controls (PwMASLD: 30.3 touchpoints per person-year [PPY]; controls: 11.1). Specifically, HCRU of PwMASLD was highest in the cirrhosis subgroup, followed by the MASH and MASLD-only subgroups (cirrhosis: 55.1 touchpoints PPY; MASH: 33.0; MASLD-only: 25.2). Physician visits (general practitioner and specialists) were the greatest category utilized across subgroups. PwMASLD incurred higher mean annual costs than controls (PwMASLD: $15,905; controls: $4,605). Mean annual costs were highest for the cirrhosis subgroup ($33,442), followed by the MASH ($18,059) and MASLD-only subgroups ($12,187). Inpatient-hospitalization was the greatest cost category across subgroups. PwMASLD with liver and/or cardiovascular health outcomes had over twice the HCRU and costs as those without.
CONCLUSIONS: PwMASLD in Ontario have higher HCRU and costs compared to controls. Moreover, in comparison to PwMASLD with MASH and MASLD alone, those with cirrhosis had the highest HCRU and costs. To alleviate the economic burden of MASLD, early diagnosis and appropriate intervention should be implemented to delay or prevent disease progression.
METHODS: PwMASLD were identified using administrative data at ICES from January 1, 2013, to December 31, 2021, and followed until December 31, 2022. PwMASLD were categorized into mutually exclusive subgroups: (1) MASLD-only without MASH and cirrhosis, (2) MASH without cirrhosis, (3) MASLD/MASH with cirrhosis. PwMASLD were matched with controls (without MASLD) on age, sex, geography, and income quintile. All-cause HCRU and costs (standardized to 2022 Canadian dollars) were reported descriptively.
RESULTS: In total, 18,202 PwMASLD and 72,770 controls were analyzed. The mean age (±standard deviation) of PwMASLD was 53.4±17.2 years, with 56% being female and 88% residing in urban areas. The MASLD-only, MASH, and cirrhosis subgroups consisted of 12,729 (70%), 2,675 (15%), and 2,798 (15%) PwMASLD, respectively. PwMASLD had 2.7-fold the HCRU of controls (PwMASLD: 30.3 touchpoints per person-year [PPY]; controls: 11.1). Specifically, HCRU of PwMASLD was highest in the cirrhosis subgroup, followed by the MASH and MASLD-only subgroups (cirrhosis: 55.1 touchpoints PPY; MASH: 33.0; MASLD-only: 25.2). Physician visits (general practitioner and specialists) were the greatest category utilized across subgroups. PwMASLD incurred higher mean annual costs than controls (PwMASLD: $15,905; controls: $4,605). Mean annual costs were highest for the cirrhosis subgroup ($33,442), followed by the MASH ($18,059) and MASLD-only subgroups ($12,187). Inpatient-hospitalization was the greatest cost category across subgroups. PwMASLD with liver and/or cardiovascular health outcomes had over twice the HCRU and costs as those without.
CONCLUSIONS: PwMASLD in Ontario have higher HCRU and costs compared to controls. Moreover, in comparison to PwMASLD with MASH and MASLD alone, those with cirrhosis had the highest HCRU and costs. To alleviate the economic burden of MASLD, early diagnosis and appropriate intervention should be implemented to delay or prevent disease progression.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE342
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity)