The effective treatment Non-alcoholic Steatohepatitis, or NASH, is a priority for the healthcare industry. NASH is a severe form of non-alcoholic fatty liver disease (NAFLD) and is a silent disease that affects 3% to 12% of adults in the United States. Liver biopsies are the gold standard in diagnosing NASH, and with the first generation of NASH therapeutics on the horizon, it is essential to understand the extent to which liver biopsies may limit access to care.

Data from Ipsos’ US Liver Diagnostic Monitor was used. The Liver Diagnostic Monitor is a perceptual study that was conducted online from September - November 2018 and captured information from 82 respondents (31 hepatologists (HEPs), 30 gastroenterologists (GASTROs), nine interventional radiologists (IRs), and 12 surgeons) that had conducted a biopsy and managed NAFLD/NASH patients. Physicians reported on attitudes, beliefs, behaviors, future trends and key metrics around diagnosis and biopsy of liver disease. Descriptive analysis was conducted using appropriate statistical tests.

Among general liver disease-treating physicians, the average wait time from deciding on the requirement for a biopsy to a patient receiving a biopsy varied by specialty, with HEPs having an average wait of 2.2 days, GASTROs 3.4 days, IRs 1.3 days, and surgeons 2.3 days. HEPs had a weekly capacity for 19 biopsies, with GASTROs, IRs and surgeons stating 15, 25 and 30, respectively. 46% of respondents stated that, in the last three months, they were at capacity for performing liver biopsies while 38% were below capacity. The 38% was driven mainly by the nine interventional radiologists, of which 67% believed they were below capacity.

Using liver biopsies for the diagnosis of NASH is resource-intensive, has limited scalability and may impact the number of patients who will be eligible for treatment.