Objective: Comorbidities such as DM accelerate the progression of NAFLD/NASH to AdvLD [compensated cirrhosis (CC)/decompensated cirrhosis (DCC)/liver transplant (LT)/hepatocellular carcinoma (HCC)]. This study examined the impact of DM on healthcare costs among NAFLD/NASH patients with AdvLD in the U.S.
Methods: Adult NAFLD/NASH patients identified from IBM Watson Health MarketScan claims database (2006-2016) were followed from initial NAFLD/NASH diagnosis to identify development of AdvLD (first diagnosis as index date), stratified by presence of DM (ICD codes/medications). Mean annual healthcare costs for each stage was obtained from per patient per month values (2016 USD). Results: Overall 468,017 NAFLD/NASH patients were identified with 24% having DM (mean age 51 years, 58% females, high comorbidity burden - 56% hypertension, 55% hyperlipidemia). Mean annual costs were higher (p<0.05) for DM vs. non-DM patients (Figure) among NAFLD/NASH, CC, and DCC patients.
Conclusions: Comorbid DM is associated with significantly higher (23-31%) healthcare costs in patients with NAFLD/NASH, CC, and DCC, which represents the majority clinical burden of NAFLD in the U.S. Novel treatment options are needed among NAFLD/NASH patients with DM to prevent progression and subsequent healthcare costs.
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. N. Kachru: Employee; Self; Gilead Sciences, Inc. Stock/Shareholder; Self; Gilead Sciences, Inc. D. Martinez: None. M. Moynihan: Employee; Self; IBM. A. Ozbay: Employee; Self; Gilead Sciences, Inc. Stock/Shareholder; Self; Gilead Sciences, Inc. S. Gordon: Consultant; Self; Gilead Sciences, Inc., Intercept Pharmaceuticals, Inc.