Objective: NAFLD/NASH patients with AF (bridging fibrosis/F3 and compensated cirrhosis/F4) have an increased risk of liver disease progression leading to higher costs, which may be compounded by presence of DM. The study evaluated the impact of DM on HRU and associated healthcare costs among NAFLD/NASH-AF patients in the U.S.
Methods: Adult NAFLD/NASH-AF patients with available lab results were identified from 2008-2016 Optum Research claims database, to calculate their Fibrosis-4 (FIB-4) score. Using the FIB-4 score, patients were categorized as F3 or F4 (first date of FIB-4 cut-off score marked the index date), and then stratified by DM (ICD codes). Mean annual HRU/costs were obtained via per patient per month values (2016 USD).
Results: Among 91,122 NAFLD/NASH patients with FIB-4 scores, 2,482 (2.7%) had F3, among which 36% had DM, and 939 (1.0%) had F4, among which 35% had DM. The mean annual costs of F3 and F4 patients with DM were 12-53% higher than non-DM (Figure) before and after the development of AF.
Conclusions: NAFLD/NASH-AF patients with DM had higher mean annual HRU-associated costs compared to those without DM - primarily driven by ambulatory and pharmacy costs. Management options are needed to improve clinical care and optimize healthcare costs among NAFLD/NASH-AF patients with DM.
S. Gordon: Consultant; Self; Gilead Sciences, Inc., Intercept Pharmaceuticals, Inc. N. Kachru: Employee; Self; Gilead Sciences, Inc. Stock/Shareholder; Self; Gilead Sciences, Inc. A. Ozbay: Employee; Self; Gilead Sciences, Inc. Stock/Shareholder; Self; Gilead Sciences, Inc. R. Wong: Advisory Panel; Self; Gilead Sciences, Inc. Consultant; Self; Gilead Sciences, Inc. Research Support; Self; Gilead Sciences, Inc. Speaker's Bureau; Self; Gilead Sciences, Inc.