COMPARATIVE HEALTHCARE BURDEN OF MASH AND NON-ALCOHOLIC CIRRHOSIS: EVIDENCE FROM AN ITALIAN REAL-WORLD ADMINISTRATIVE DATABASE
Author(s)
Letizia Dondi, BS1, Leonardo Dondi, BS1, Irene Dell'Anno, PhD1, Nicola Ambrosio, PhD1, Giulia Ronconi, PharmD1, Alice Addesi, MSc1, Immacolata Esposito, PhD1, Nello Martini, PharmD1, Michele Intorcia, MSc2, Carlo Piccinni, PhD1.
1Fondazione Ricerca e Salute (ReS) - Research and Health Foundation, Roma, Italy, 2Madrigal Pharmaceuticals, MIlano, Italy.
1Fondazione Ricerca e Salute (ReS) - Research and Health Foundation, Roma, Italy, 2Madrigal Pharmaceuticals, MIlano, Italy.
OBJECTIVES: Metabolic dysfunction-associated steatotic liver disease may progress to steatohepatitis (MASH) and ultimately cirrhosis. In Italy, no disease-specific pharmacological treatments are currently approved. This study aimed to compare the healthcare burden of patients with incident hospital-recorded MASH or non-alcoholic cirrhosis within the Italian National Health Service (SSN).
METHODS: This retrospective observational study used the Fondazione ReS administrative database (~5.1 million inhabitants in 2022). Individuals continuously recorded for ≥3 years were included. Incident MASH (ICD-9-CM 571.8/571.9; excluding cirrhosis and viral hepatitis) and incident non-alcoholic cirrhosis (571.5; excluding viral hepatitis) were defined as first hospital-recorded diagnoses in 2022 with no prior evidence in the look-back period. Baseline demographics and comorbidities were described. Healthcare resource utilization and direct medical costs (hospitalizations, pharmaceuticals, outpatient services, emergency room visits) reimbursed by the SSN were assessed over 12 months before the index date.
RESULTS: In 2022, 2,069 incident MASH and 942 incident cirrhosis cases were identified. Patients with cirrhosis were older and exhibited a higher comorbidity burden. Across all care settings, cirrhosis was associated with greater healthcare utilization, including higher hospitalization rates, more frequent admissions (2.1 vs 1.6 per patient), longer length of stay (12.4 vs 11.0 days), and more frequent emergency and outpatient service use. Mean annual per-capita costs during follow-up were higher in cirrhosis than in MASH (€7,980 vs €4,810), primarily driven by hospitalizations (67.5% vs 53.6% of total costs). Liver transplantation contributed more substantially to total costs in cirrhosis (17.3% vs 2.0%), while outpatient monitoring services accounted for a limited proportion of overall costs (~0.5-0.6%).
CONCLUSIONS: In this real-world administrative analysis, patients with incident hospital-recorded non-alcoholic cirrhosis showed substantially higher healthcare utilization and costs compared with those with MASH. These findings highlight the increased clinical and economic burden associated with advanced disease stages, supporting the need for earlier identification and management of patients with MASH.
METHODS: This retrospective observational study used the Fondazione ReS administrative database (~5.1 million inhabitants in 2022). Individuals continuously recorded for ≥3 years were included. Incident MASH (ICD-9-CM 571.8/571.9; excluding cirrhosis and viral hepatitis) and incident non-alcoholic cirrhosis (571.5; excluding viral hepatitis) were defined as first hospital-recorded diagnoses in 2022 with no prior evidence in the look-back period. Baseline demographics and comorbidities were described. Healthcare resource utilization and direct medical costs (hospitalizations, pharmaceuticals, outpatient services, emergency room visits) reimbursed by the SSN were assessed over 12 months before the index date.
RESULTS: In 2022, 2,069 incident MASH and 942 incident cirrhosis cases were identified. Patients with cirrhosis were older and exhibited a higher comorbidity burden. Across all care settings, cirrhosis was associated with greater healthcare utilization, including higher hospitalization rates, more frequent admissions (2.1 vs 1.6 per patient), longer length of stay (12.4 vs 11.0 days), and more frequent emergency and outpatient service use. Mean annual per-capita costs during follow-up were higher in cirrhosis than in MASH (€7,980 vs €4,810), primarily driven by hospitalizations (67.5% vs 53.6% of total costs). Liver transplantation contributed more substantially to total costs in cirrhosis (17.3% vs 2.0%), while outpatient monitoring services accounted for a limited proportion of overall costs (~0.5-0.6%).
CONCLUSIONS: In this real-world administrative analysis, patients with incident hospital-recorded non-alcoholic cirrhosis showed substantially higher healthcare utilization and costs compared with those with MASH. These findings highlight the increased clinical and economic burden associated with advanced disease stages, supporting the need for earlier identification and management of patients with MASH.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH117
Topic
Economic Evaluation, Epidemiology & Public Health, Real World Data & Information Systems
Disease
Gastrointestinal Disorders