ECONOMIC BURDEN OF DIAGNOSED METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE (MASLD) IN US ADULTS WITH TYPE 2 DIABETES: A RETROSPECTIVE COHORT STUDY
Author(s)
Tien Hoang Tran, PharmD, MPH1, John Kim, MHS2, Rozalina McCoy, MD, MS3, Zafar Zafari, PhD2;
1University of Maryland School of Pharmacy, Baltimore, MD, USA, 2University of Maryland Baltimore, Baltimore, MD, USA, 3University of Maryland School of Medicine, Baltimore, MD, USA, Baltimore, MD, USA
1University of Maryland School of Pharmacy, Baltimore, MD, USA, 2University of Maryland Baltimore, Baltimore, MD, USA, 3University of Maryland School of Medicine, Baltimore, MD, USA, Baltimore, MD, USA
OBJECTIVES: Adults with type 2 diabetes (T2DM) are at high risk for MASLD, yet contemporary, real-world estimates of the incremental healthcare costs attributable to diagnosed MASLD in this population are limited. To address this gap, we estimated 12-month direct medical costs associated with diagnosed MASLD among adults with T2DM compared with those without diagnosed MASLD.
METHODS: Using IQVIA PharMetrics® Plus for Academics claims (2016-2025), we identified adults aged 18-64 with continuous medical and pharmacy enrollment for 12 months before and after the index date, defined as the first qualifying T2DM diagnosis (≥1 inpatient claim or ≥2 outpatient claims with ICD-10-CM E11.xx on distinct dates). MASLD was operationalized using a validated, claims-based algorithm requiring ≥1 inpatient claim or ≥2 outpatient claims on different dates with ICD-10-CM K76.0, and excluding competing etiologies (e.g., alcohol-associated liver disease, viral hepatitis, autoimmune/genetic liver diseases, primary liver cancer). MASLD and non-MASLD cohorts were propensity score-matched 1:1 on demographics, regions, baseline comorbidities, comedications, and baseline utilization/costs. Follow-up all-cause direct medical costs (health plan paid + patient cost share) were summed over 12 months post-index and compared using generalized linear models (gamma distribution; log link) to estimate adjusted mean costs and 95% confidence intervals (CIs).
RESULTS: We identified 8,235 adults with T2DM and diagnosed MASLD. Before matching, MASLD patients had higher prevalence of obesity (64.7% vs 44.3%) and severe obesity (34.2% vs 19.0%). In the matched cohort, adjusted mean annual direct medical costs were higher for MASLD versus controls ($23,835; 95% CI $22,207-$26,706 vs $15,154; 95% CI $13,819-$16,618), an incremental difference of $8,681 per patient-year.
CONCLUSIONS: Among US adults with T2DM, diagnosed MASLD is associated with substantial incremental 12-month direct medical costs, underscoring the economic burden of MASLD in this high-risk population.
METHODS: Using IQVIA PharMetrics® Plus for Academics claims (2016-2025), we identified adults aged 18-64 with continuous medical and pharmacy enrollment for 12 months before and after the index date, defined as the first qualifying T2DM diagnosis (≥1 inpatient claim or ≥2 outpatient claims with ICD-10-CM E11.xx on distinct dates). MASLD was operationalized using a validated, claims-based algorithm requiring ≥1 inpatient claim or ≥2 outpatient claims on different dates with ICD-10-CM K76.0, and excluding competing etiologies (e.g., alcohol-associated liver disease, viral hepatitis, autoimmune/genetic liver diseases, primary liver cancer). MASLD and non-MASLD cohorts were propensity score-matched 1:1 on demographics, regions, baseline comorbidities, comedications, and baseline utilization/costs. Follow-up all-cause direct medical costs (health plan paid + patient cost share) were summed over 12 months post-index and compared using generalized linear models (gamma distribution; log link) to estimate adjusted mean costs and 95% confidence intervals (CIs).
RESULTS: We identified 8,235 adults with T2DM and diagnosed MASLD. Before matching, MASLD patients had higher prevalence of obesity (64.7% vs 44.3%) and severe obesity (34.2% vs 19.0%). In the matched cohort, adjusted mean annual direct medical costs were higher for MASLD versus controls ($23,835; 95% CI $22,207-$26,706 vs $15,154; 95% CI $13,819-$16,618), an incremental difference of $8,681 per patient-year.
CONCLUSIONS: Among US adults with T2DM, diagnosed MASLD is associated with substantial incremental 12-month direct medical costs, underscoring the economic burden of MASLD in this high-risk population.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE437
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Gastrointestinal Disorders