ECONOMIC EVALUATION OF COENZYME Q10 ADDED TO LIFESTYLE MODIFICATION IN METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE: EVIDENCE FROM A RANDOMIZED CONTROLLED TRIAL
Author(s)
Mariam T. Seif, BSc, MSc1, Abanoub T. Seif, BSc2.
1Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt, 2Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
1Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt, 2Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
OBJECTIVES: Metabolic dysfunction-associated fatty liver disease (MAFLD) is an increasing public health burden associated with progressive fibrosis and rising healthcare utilization. Evidence on the economic value of coenzyme Q10 (CoQ10) in MAFLD remains limited. This study assessed the cost-effectiveness of CoQ10 added to lifestyle modification (LSM) compared with LSM alone in patients with MAFLD.
METHODS: A trial-based cost-effectiveness analysis was conducted from the healthcare payer perspective in Egypt using data from an open-label randomized controlled trial involving 72 patients (36 per group) over 3 months. Direct medical costs included CoQ10 acquisition, adverse event management, laboratory monitoring, imaging, and follow-up visits. Laboratory, imaging and follow-up costs were identical between groups and therefore did not contribute to incremental cost differences. Costs are reported in 2024 Egyptian Pounds (EGP) (31 EGP = 1 USD). Effectiveness was defined as improvement of at least one fibrosis stage. The incremental cost-effectiveness ratio (ICER) was calculated as cost per additional fibrosis responder.
RESULTS: Fibrosis response was significantly higher in CoQ10 group compared with the LSM alone (19/36 vs 3/36; 52.8% vs 8.3%; χ²=16.8, p<0.001). Mean cost per patient was EGP 66.0 in the CoQ10 group versus EGP 14.1 in the control group, yielding an incremental cost of EGP 51.94. Incremental effectiveness was 44.5%, resulting in an ICER of EGP 116.98 per additional fibrosis responder. One-way sensitivity analysis varying CoQ10 cost by ±20% produced ICERs ranging from EGP 93.6 to EGP 140.4 per additional responder.
CONCLUSIONS: CoQ10 added to lifestyle modification significantly improved fibrosis stage response over 3 months while incurring modest incremental costs. Within the trial time horizon and assumptions, CoQ10 demonstrated a favorable cost-effectiveness profile; however, longer-term studies are needed to confirm the durability of clinical benefit and economic value in MAFLD.
METHODS: A trial-based cost-effectiveness analysis was conducted from the healthcare payer perspective in Egypt using data from an open-label randomized controlled trial involving 72 patients (36 per group) over 3 months. Direct medical costs included CoQ10 acquisition, adverse event management, laboratory monitoring, imaging, and follow-up visits. Laboratory, imaging and follow-up costs were identical between groups and therefore did not contribute to incremental cost differences. Costs are reported in 2024 Egyptian Pounds (EGP) (31 EGP = 1 USD). Effectiveness was defined as improvement of at least one fibrosis stage. The incremental cost-effectiveness ratio (ICER) was calculated as cost per additional fibrosis responder.
RESULTS: Fibrosis response was significantly higher in CoQ10 group compared with the LSM alone (19/36 vs 3/36; 52.8% vs 8.3%; χ²=16.8, p<0.001). Mean cost per patient was EGP 66.0 in the CoQ10 group versus EGP 14.1 in the control group, yielding an incremental cost of EGP 51.94. Incremental effectiveness was 44.5%, resulting in an ICER of EGP 116.98 per additional fibrosis responder. One-way sensitivity analysis varying CoQ10 cost by ±20% produced ICERs ranging from EGP 93.6 to EGP 140.4 per additional responder.
CONCLUSIONS: CoQ10 added to lifestyle modification significantly improved fibrosis stage response over 3 months while incurring modest incremental costs. Within the trial time horizon and assumptions, CoQ10 demonstrated a favorable cost-effectiveness profile; however, longer-term studies are needed to confirm the durability of clinical benefit and economic value in MAFLD.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE328
Topic
Clinical Outcomes, Economic Evaluation, Study Approaches
Topic Subcategory
Trial-Based Economic Evaluation
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), No Additional Disease & Conditions/Specialized Treatment Areas