LIVERMULTISCAN AS A NON-INVASIVE ALTERNATIVE TO LIVER BIOPSY FOR MONITORING PAEDIATRIC AUTOIMMUNE HEPATITIS: A MULTI-REGION ECONOMIC EVALUATION
Author(s)
Megh Utsav, BA, MSc1, Kamil Janowski, PhD, MD2, Prashant Pandya, MD1, Piotr Socha, PhD2, Elizabeth Shumbayawonda, PhD1.
1Perspectum Ltd., Oxford, United Kingdom, 2Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland.
1Perspectum Ltd., Oxford, United Kingdom, 2Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland.
OBJECTIVES: There is a growing need to use non-invasive tests (NITs) to support patient management especially as liver biopsies carry significant complications. However, only 3% of NITs are currently approved by regulators for use in paediatrics (children and young adults). An adult study has shown significant cost savings using multiparametric magnetic resonance (mpMR) when liver biopsy frequency is either reduced or eliminated. Similarly, we investigated the affordability of mpMR as an alternative to liver biopsy in paediatric patients with autoimmune hepatitis (AIH) with quiescent disease who can avoid having a liver biopsy.
METHODS: A decision-analytic cohort model evaluating the costs associated with following 100 patients with quiescent disease over a 6-year period was conducted from multiple national payer perspectives (USA, UK and Europe [Germany, Netherlands, Greece]). The diagnostic and biopsy-related complication costs were calculated using CPT/ICD/tariff codes or were taken from literature. Sensitivity analyses modelling the cost consequences of increasing the frequency of mpMR monitoring with two fixed biopsies over 6-years were conducted.
RESULTS: Two scenarios were evaluated with savings compared to the base case (serial biennial liver biopsies as recommended by clinical guidelines): scenario1: replacing one biopsy and scenario2: replacing two biopsies with mpMR scans over the 6-year period. In the USA, scenario1 resulted in cost-savings of $81,300, increasing to $162,600 for scenario2. Similarly in the UK and Europe cost-savings were £42,600 and £85,300, and €23,500 and €47,100 respectively. Sensitivity analysis with two fixed biopsies over 6-years showed that annual mpMR is cost-saving in both the US ($5,892) and UK (£6,399) while biennial mpMR screening is cost-saving in Europe (€565).
CONCLUSIONS: Our findings reflect those seen in adults and show that integration of mpMR scans in paediatric AIH patient pathways can lead to significant cost savings when liver biopsy frequency is reduced in those with quiescent disease.
METHODS: A decision-analytic cohort model evaluating the costs associated with following 100 patients with quiescent disease over a 6-year period was conducted from multiple national payer perspectives (USA, UK and Europe [Germany, Netherlands, Greece]). The diagnostic and biopsy-related complication costs were calculated using CPT/ICD/tariff codes or were taken from literature. Sensitivity analyses modelling the cost consequences of increasing the frequency of mpMR monitoring with two fixed biopsies over 6-years were conducted.
RESULTS: Two scenarios were evaluated with savings compared to the base case (serial biennial liver biopsies as recommended by clinical guidelines): scenario1: replacing one biopsy and scenario2: replacing two biopsies with mpMR scans over the 6-year period. In the USA, scenario1 resulted in cost-savings of $81,300, increasing to $162,600 for scenario2. Similarly in the UK and Europe cost-savings were £42,600 and £85,300, and €23,500 and €47,100 respectively. Sensitivity analysis with two fixed biopsies over 6-years showed that annual mpMR is cost-saving in both the US ($5,892) and UK (£6,399) while biennial mpMR screening is cost-saving in Europe (€565).
CONCLUSIONS: Our findings reflect those seen in adults and show that integration of mpMR scans in paediatric AIH patient pathways can lead to significant cost savings when liver biopsy frequency is reduced in those with quiescent disease.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE84
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)