FACTORS ASSOCIATED WITH HEALTHCARE COSTS AND DISEASE PROGRESSION IN METABOLIC DYSFUNCTION-ASSOCIATED STEATOHEPATITIS IN THE US REAL-WORLD SETTING
Author(s)
Yestle Kim, MSc, PharmD1, Ni Zeng, PhD2, Jessamine Winer-Jones, PhD3, Mac Bonafede, MPH, PhD2, John O'Donnell, PhD, MS1, Taylor Ryan, MHI2;
1Madrigal Pharmaceuticals, West Conshohocken, PA, USA, 2Veradigm, Chicago, IL, USA, 3Veradigm, Sr. Manager, Publications, Chapel Hill, NC, USA
1Madrigal Pharmaceuticals, West Conshohocken, PA, USA, 2Veradigm, Chicago, IL, USA, 3Veradigm, Sr. Manager, Publications, Chapel Hill, NC, USA
OBJECTIVES: To model healthcare costs and progression to advanced or end-stage liver disease (ESLD: cirrhosis, decompensated cirrhosis, liver transplant, hepatocellular carcinoma) among adults with metabolic dysfunction-associated steatohepatitis (MASH).
METHODS: Adults (18+) with ≥1 inpatient claim or ≥2 outpatient claims/records with a MASH diagnosis (ICD-10-CM: K75.81) between 07/01/2019-04/30/2025 (earliest diagnosis=index) were identified in the Veradigm Network EHR linked to claims. Patients were required to have: non-missing age or sex; no evidence of resmetirom use; continuous enrollment ≥2 years pre-index (baseline [includes index]) and ≥1 year post-index (follow-up); and no evidence of other causes of liver disease (e.g., viral hepatitis) during the study period. All models included age, sex, race, and baseline FIB-4 score (where available) as covariates. The time to disease progression among those without baseline ESLD model included a composite flag for baseline type 2 diabetes (T2D), obesity, or hypertension. Total healthcare costs were modeled among patients with and without T2D (primary predictor: baseline ESLD). Additional cost model covariates included baseline obesity, hypertension, dyslipidemia, and hypertension*dyslipidemia.
RESULTS: Among 68,209 patients with MASH, 19,741 patients had ESLD at index, while 7,367 patients without index ESLD progressed during follow-up (average follow-up was 2.8 [1.3] years). Among those without baseline ESLD, the presence of baseline T2D, obesity, or hypertension was associated with a 56.7% increase in the hazard of disease progression. Other factors significantly associated with an increased hazard were older age, higher baseline FIB-4, and female sex. Baseline ESLD was associated with roughly a doubling of healthcare costs for patients with and without T2D. Directional effects of other factors, such as sex, race, FIB-4, and baseline dyslipidemia, differed somewhat between patients with and without T2D.
CONCLUSIONS: These models highlight factors associated with increased risk of disease progression and higher costs among patients with noncirrhotic MASH, improving our understanding of this heterogeneous population.
METHODS: Adults (18+) with ≥1 inpatient claim or ≥2 outpatient claims/records with a MASH diagnosis (ICD-10-CM: K75.81) between 07/01/2019-04/30/2025 (earliest diagnosis=index) were identified in the Veradigm Network EHR linked to claims. Patients were required to have: non-missing age or sex; no evidence of resmetirom use; continuous enrollment ≥2 years pre-index (baseline [includes index]) and ≥1 year post-index (follow-up); and no evidence of other causes of liver disease (e.g., viral hepatitis) during the study period. All models included age, sex, race, and baseline FIB-4 score (where available) as covariates. The time to disease progression among those without baseline ESLD model included a composite flag for baseline type 2 diabetes (T2D), obesity, or hypertension. Total healthcare costs were modeled among patients with and without T2D (primary predictor: baseline ESLD). Additional cost model covariates included baseline obesity, hypertension, dyslipidemia, and hypertension*dyslipidemia.
RESULTS: Among 68,209 patients with MASH, 19,741 patients had ESLD at index, while 7,367 patients without index ESLD progressed during follow-up (average follow-up was 2.8 [1.3] years). Among those without baseline ESLD, the presence of baseline T2D, obesity, or hypertension was associated with a 56.7% increase in the hazard of disease progression. Other factors significantly associated with an increased hazard were older age, higher baseline FIB-4, and female sex. Baseline ESLD was associated with roughly a doubling of healthcare costs for patients with and without T2D. Directional effects of other factors, such as sex, race, FIB-4, and baseline dyslipidemia, differed somewhat between patients with and without T2D.
CONCLUSIONS: These models highlight factors associated with increased risk of disease progression and higher costs among patients with noncirrhotic MASH, improving our understanding of this heterogeneous population.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO15
Topic
Clinical Outcomes
Topic Subcategory
Relating Intermediate to Long-term Outcomes
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Gastrointestinal Disorders