Disease burden and economic impact of diagnosed non-alcoholic steatohepatitis (NASH) in the United Kingdom (UK) in 2018

Alice Morgan (), Sally Hartmanis, Emmanuel Tsochatzis, Philip N. Newsome, Stephen D. Ryder, Rachel Elliott, Lefteris Floros, Richard Hall, Victoria Higgins, George Stanley, Sandrine Cure, Sharad Vasudevan and Lynne Pezzullo
Additional contact information
Alice Morgan: Deloitte
Sally Hartmanis: Deloitte
Emmanuel Tsochatzis: UCL Institute for Liver and Digestive Health, Royal Free Hospital
Philip N. Newsome: National Institute for Health Research Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and the University of Birmingham
Stephen D. Ryder: National Institute for Health Research Nottingham Biomedical Research Centre at Nottingham University Hospitals NHS Trust and the University of Nottingham
Rachel Elliott: University of Manchester
Lefteris Floros: PHMR Limited
Richard Hall: Liver4Life
Victoria Higgins: Adelphi Real World
George Stanley: Intercept Pharmaceuticals
Sandrine Cure: Intercept Pharmaceuticals
Sharad Vasudevan: Deloitte
Lynne Pezzullo: Deloitte

The European Journal of Health Economics, 2021, vol. 22, issue 4, No 2, 505-518

Abstract: Abstract Background and aims Non-alcoholic steatohepatitis (NASH) – a progressive subset of non-alcoholic fatty liver disease (NAFLD) – is a chronic liver disease that can progress to advanced fibrosis, cirrhosis, and end-stage liver disease (ESLD) if left untreated. Early-stage NASH is usually asymptomatic, meaning a large proportion of the prevalent population are undiagnosed. Receiving a NASH diagnosis increases the probability that a patient will receive interventions for the purpose of managing their condition. The purpose of this study was to estimate the disease burden and economic impact of diagnosed NASH in the United Kingdom (UK) adult population in 2018. Methods The socioeconomic burden of diagnosed NASH from a societal perspective was estimated using cost-of-illness methodology applying a prevalence approach. This involved estimating the number of adults with diagnosed NASH in the UK in a base period (2018) and the economic and wellbeing costs attributable to diagnosed NASH in that period. The analysis was based on a targeted review of the scientific literature, existing databases and consultation with clinical experts, health economists and patient groups. Results Of the prevalent NASH population in the UK in 2018, an estimated 79.8% were not diagnosed. In particular, of the prevalent population in disease stages F0 to F2, only 2.0% (F0), 2.0% (F1) and 16.5% (F2), respectively, were diagnosed. Total economic costs of diagnosed NASH in the UK ranged from £2.3 billion (lower prevalence scenario, base probability of diagnosis scenario) to £4.2 billion (higher prevalence scenario, base probability of diagnosis scenario). In 2018, people with NASH in the UK were estimated to experience 94,094 to 174,564 disability-adjusted life years (DALYs) overall. Total wellbeing costs associated with NASH in 2018 were estimated to range between £5.6 to £10.5 billion. Conclusion The prevention and appropriate management of adult NASH patients could result in reduced economic costs and improvements in wellbeing.

Keywords: Cost-of-illness analysis; Non-alcoholic steatohepatitis (NASH); Burden of disease; Economic impact; Health care resource utilisation (search for similar items in EconPapers)
JEL-codes: I11 I12 I18 I39 (search for similar items in EconPapers)
Date: 2021
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DOI: 10.1007/s10198-020-01256-y

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