PROGRESSION OF METABOLIC DYSFUNCTION-ASSOCIATED STEATOHEPATITIS AND ECONOMIC BURDEN: USE OF REAL-WORLD HEALTH RECORD DATA IN ENGLAND TO INFORM ECONOMIC MODELS
Author(s)
Jennifer A. Davidson, PhD1, Hannah R. Brewer, PhD1, Caoimhe Treise Rice, MA, MSc, MD2, Sara J. Carvalho, PhD1, Yestle Kim, MSc, PharmD3.
1Thermo Fisher Scientific, London, United Kingdom, 2Thermo Fischer Scientific, Bristol, United Kingdom, 3Madrigal Pharmaceuticals, Jersey City, NJ, USA.
1Thermo Fisher Scientific, London, United Kingdom, 2Thermo Fischer Scientific, Bristol, United Kingdom, 3Madrigal Pharmaceuticals, Jersey City, NJ, USA.
OBJECTIVES: Economic burden of metabolic dysfunction-associated steatohepatitis (MASH) is not well characterized, and data are required to inform economic models to demonstrate the impact of progression to advanced liver disease (ALD). This study characterised clinically coded ALD outcomes among patients with MASH in England.
METHODS: A cohort study was conducted using linked Clinical Practice Research Datalink Aurum, Hospital Episode Statistics and death registration datasets. Adults diagnosed with MASH (2011-2020) were followed for clinically coded progression to compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), liver transplant, and death. Kaplan-Meier analyses estimated time free from progression and survival probabilities. Mean all-cause costs were calculated per-patient per-year (PPPY) and inflated to 2024/25 £ among patients with at least 12 months of follow-up.
RESULTS: Among 2,696 patients with MASH, 356 patients experienced progression to ≥1 clinically coded ALD state during observed follow-up (mean 4 years). There were 234 patients who progressed to CC (65.7%), 174 to DCC (48.9% overall; 31.0% for patients with known prior CC [n=54]) and 18 developed HCC (5.1% overall; 61.1% for prior CC patients [n=11]). Among patients progressing to CC, DCC, and HCC, median time to progression was 1.43, 1.74, and 1.11 years, respectively. Among patients who progressed to cirrhosis (n=349), inpatient costs were numerically higher (£4,236 vs £1,509 PPPY) than those without progression (n=2,347). Among DCC (n=163), healthcare costs were £7,009 PPPY within the first year of follow-up and £7,932 PPPY in the second year. For HCC (n=14), corresponding costs were £5,112 and £6,404 PPPY.
CONCLUSIONS: This real-world data provides clinically interpretable progression and cost estimates for ALD health states in MASH. CC, DCC, and HCC outcomes map readily to later-stage economic model structures; however, healthcare datasets often capture clinical diagnoses rather than fibrosis stages and additional assumptions are warranted when considering all progression events.
METHODS: A cohort study was conducted using linked Clinical Practice Research Datalink Aurum, Hospital Episode Statistics and death registration datasets. Adults diagnosed with MASH (2011-2020) were followed for clinically coded progression to compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), liver transplant, and death. Kaplan-Meier analyses estimated time free from progression and survival probabilities. Mean all-cause costs were calculated per-patient per-year (PPPY) and inflated to 2024/25 £ among patients with at least 12 months of follow-up.
RESULTS: Among 2,696 patients with MASH, 356 patients experienced progression to ≥1 clinically coded ALD state during observed follow-up (mean 4 years). There were 234 patients who progressed to CC (65.7%), 174 to DCC (48.9% overall; 31.0% for patients with known prior CC [n=54]) and 18 developed HCC (5.1% overall; 61.1% for prior CC patients [n=11]). Among patients progressing to CC, DCC, and HCC, median time to progression was 1.43, 1.74, and 1.11 years, respectively. Among patients who progressed to cirrhosis (n=349), inpatient costs were numerically higher (£4,236 vs £1,509 PPPY) than those without progression (n=2,347). Among DCC (n=163), healthcare costs were £7,009 PPPY within the first year of follow-up and £7,932 PPPY in the second year. For HCC (n=14), corresponding costs were £5,112 and £6,404 PPPY.
CONCLUSIONS: This real-world data provides clinically interpretable progression and cost estimates for ALD health states in MASH. CC, DCC, and HCC outcomes map readily to later-stage economic model structures; however, healthcare datasets often capture clinical diagnoses rather than fibrosis stages and additional assumptions are warranted when considering all progression events.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE639
Topic
Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity)