Factors Associated with High Costs of Patients with Non-Alcoholic Fatty Liver Disease: An Observational Study Using the French Constances Cohort
Author(s)
Arnaud NO1, Brzustowski A2, Paradis V3, Van Beers B4, Postic C2, Laouénan C5, Pol S6, Castéra L7, Gautier JF8, Czernichow S9, Vallet-Pichard A10, Larger E11, Serfaty L12, Zins M13, Valla D14, Durand Zaleski I15
1DRCI-URC Eco Ile-de-France (AP-HP), Assistance Publique-Hôpitaux de Paris, paris, Ile de France, France, 22. Université Paris Cité, INSERM, Centre de recherche sur l’inflammation, F-75018, Paris, Ile de France, France, 33. Université Paris Cité, Paris, France AP-HP, Hôpital Beaujon, 92110 Clichy, France Service Anatomie et cytologie pathologiques, INSERM, Centre de recherche sur l’inflammation, F-75018, Paris, Ile de France, France, 44. Radiology, AP-HP, Hôpital Beaujon, 92110 Clichy, France, Paris, Ile de France, France, 55. Université Paris Cité, INSERM, IAME UMR 1137, Paris, France, AP-HP.Nord, Hôpital Bichat, Département d'Epidémiologie Biostatistique et Recherche Clinique, Paris, France, Paris, Ile de France, France, 67. Liver department, Hôpital Cochin-APHP ; Université Paris Cité, Paris, France, Paris, Ile de France, France, 78. Hepatology department, Hôpital Beaujon, AP-HP, Université Paris Cité, INSERM UMR 1149, CRI, Clichy, France, Paris, Ile de France, France, 81. Université Paris Cité, Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière group and Inserm U1151, Service de diabétologie et d’endocrinologie – Centre Universitaire du Diabète et de ses Complications, Paris France, Paris, Ile de France, France, 910. Université de Paris-Cité and Université Sorbonne Paris Nord, Paris, France, Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Nutrition, Centre Spécialisé Obésité, Hôpital Européen Georges Pompidou, Paris, France, Centre of Research in Epidemi, Paris, Ile de France, France, 1011. Université Paris Cité, Liver department, Hôpital Cochin-APHP ; Paris, France, Paris, Ile de France, France, 1112. Université Paris Cité, Diabetology department, Hôpital Cochin-APHP ; Paris, France, Paris, Ile de France, France, 12Hôpitaux Universitaires de Strasbourg, Strasbourg, France, 13Université Paris-Saclay, UVSQ, Inserm, Cohortes Epidémiologiques en population, Villejuif, France, 1415. Service hépatologie, AP-HP, Hôpital Beaujon, 92110 Clichy, France, Paris, Ile de France, France, 15Professor of Public Health Medicine and Doctor of Economics. Director of URCEco, Paris, Ile-de-France, France
Presentation Documents
OBJECTIVES: In the western world the prevalence of non-alcoholic fatty liver disease (NAFLD) is between 20% and 30% yet little targeted pharmacological therapy available. Understanding the risk factors and healthcare utilization in this population could help to identify efficient interventions and improve outcomes. This research evaluates healthcare utilization and identifies factors associated with high-cost NAFLD patients in France.
METHODS: The prevalent population with NAFLD (including non-alcoholic steatohepatitis) in the CONSTANCES cohort, a nationally representative sample of 200,000 adults aged between 18 and 69, was linked to the French centralized national claims database (SNDS). Study participants were identified by the fatty liver index (FLI) over the period 2015/2019, having submitted at least one healthcare claim during 2019 and alive on 31st December 2019. NAFLD individuals were classified according as “high-cost” (above 90th percentile) or “non-high cost” (below 90th percentile). Factors significantly associated with high costs were identified using a multivariate logistic regression model.
RESULTS: A total of 14,437 predominantly male participants were included with an average age of 53 ± SD 12 years. They mainly belong to socially deprived population groups with co-morbidities such as diabetes, high blood pressure, mental health disorders and cardiovascular complications. The average expenditure was estimated at €1,860 ± SD 4,634 per year. High-cost NAFLD cost €10,863± SD 10,859 per year. Conditions associated with high-cost were mental health disorders OR 1.79 (1.44-2.22), cardiovascular diseases OR 1.54 (1.21-1.95), metabolic comorbidities OR 1.50 (1.25-1.81), and respiratory disease OR 1.50 (1.11-2.00). The 10% high-cost participants accounted for 58% of the total national health care expenditures for NAFLD.
CONCLUSIONS: Given the lack of therapeutic options available, analysis of RWD can identify the multi-morbidity risk factors of high-cost users with NAFLD and help to identify interventions to improve the NAFLD pathway. The economic impact of these interventions can be estimated.
Conference/Value in Health Info
Value in Health, Volume 26, Issue 11, S2 (December 2023)
Code
RWD112
Topic
Economic Evaluation, Study Approaches
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity)