ECONOMIC AND HUMANISTIC BURDEN OF COMPENSATED METABOLIC DYSFUNCTION-ASSOCIATED STEATOHEPATITIS (MASH) CIRRHOSIS: A SYSTEMATIC LITERATURE REVIEW
Author(s)
Yestle Kim, MSc, PharmD1, latashree Goswami, MPH2, Atish De, MS2, Nipun Atreja, MS, PhD1, Karen Phillips, PharmD, BCPS1, Danielle Zielinski, PharmD1, Nandini Hadker, MA2.
1Madrigal Pharmaceuticals, West Conshohocken, PA, USA, 2Trinity Life Sciences, Waltham, MA, USA.
1Madrigal Pharmaceuticals, West Conshohocken, PA, USA, 2Trinity Life Sciences, Waltham, MA, USA.
OBJECTIVES: Compensated metabolic dysfunction-associated steatohepatitis (MASH) cirrhosis (MASH F4c) represents a substantial increase in severity vs. earlier stages, yet data in this population have not been comprehensively synthesized. This systematic literature review was conducted to characterize economic and humanistic outcomes in MASH F4c, highlighting healthcare resource use (HCRU) and disease management-associated costs, as well as patient-reported outcomes (PROs) and health-related quality of life (HRQoL) measures.
METHODS: Protocol- and PRISMA-driven searches were conducted in Embase and PubMed (2017-February 2026 for articles; 2021-February 2026 for conference abstracts). Studies with adults with MASH F4c in the US, UK, France, Germany, Italy and Spain were included if they reported epidemiological, clinical, economic, or humanistic outcomes. Title/abstract and full-text screening was performed in duplicate. All extractions were conducted by one reviewer and independently validated by another.
RESULTS: A total of 11 studies reporting economic and humanistic burden were identified. Economic burden estimates were heterogeneous in data source and outcome definition, driven primarily by single-country retrospective analyses. Underlying methodologies did not permit clear attribution of all HCRU and costs specifically to F4c vs. other comorbidities. Humanistic data were sparse and focused on generic and liver-specific QoL instruments; no studies comprehensively evaluated disability, activities of daily living, or the psychological and social burden associated with MASH F4c.
CONCLUSIONS: Evidence in MASH F4c is methodologically and numerically heterogeneous. Data are insufficient to isolate MASH-attributable HCRU and costs; or to characterize functional, psychological, and social impacts. As costs of progression to decompensated cirrhosis are substantial ($181,036 per patient, per a 2024 US Medicare analysis), additional robust, multi-country, MASH-specific economic and humanistic studies are needed to fully understand patient burden and cost impact in F4c and prevent more severe disease states.
METHODS: Protocol- and PRISMA-driven searches were conducted in Embase and PubMed (2017-February 2026 for articles; 2021-February 2026 for conference abstracts). Studies with adults with MASH F4c in the US, UK, France, Germany, Italy and Spain were included if they reported epidemiological, clinical, economic, or humanistic outcomes. Title/abstract and full-text screening was performed in duplicate. All extractions were conducted by one reviewer and independently validated by another.
RESULTS: A total of 11 studies reporting economic and humanistic burden were identified. Economic burden estimates were heterogeneous in data source and outcome definition, driven primarily by single-country retrospective analyses. Underlying methodologies did not permit clear attribution of all HCRU and costs specifically to F4c vs. other comorbidities. Humanistic data were sparse and focused on generic and liver-specific QoL instruments; no studies comprehensively evaluated disability, activities of daily living, or the psychological and social burden associated with MASH F4c.
CONCLUSIONS: Evidence in MASH F4c is methodologically and numerically heterogeneous. Data are insufficient to isolate MASH-attributable HCRU and costs; or to characterize functional, psychological, and social impacts. As costs of progression to decompensated cirrhosis are substantial ($181,036 per patient, per a 2024 US Medicare analysis), additional robust, multi-country, MASH-specific economic and humanistic studies are needed to fully understand patient burden and cost impact in F4c and prevent more severe disease states.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE27
Topic
Economic Evaluation, Patient-Centered Research
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)