Economic Burden of Non-Alcoholic Steatohepatitis (NASH) Among Diabetic Population in Italy: Analysis and Perspectives.
burden of illness
non-alcoholic steatohepatitis
treatment perspectives
type 2 diabetes mellitus
Journal
ClinicoEconomics and outcomes research : CEOR
ISSN: 1178-6981
Titre abrégé: Clinicoecon Outcomes Res
Pays: New Zealand
ID NLM: 101560564
Informations de publication
Date de publication:
2022
2022
Historique:
received:
06
05
2022
accepted:
10
08
2022
entrez:
21
9
2022
pubmed:
22
9
2022
medline:
22
9
2022
Statut:
epublish
Résumé
Aim of our study is to evaluate the economic impact of NASH among diabetic population in Italy and potential benefits of treatments that can slow the disease progression. A Markov model was conducted from the Italian National Healthcare System perspective reporting results at 3, 5, 10 and 15 years. The model included NASH and T2DM patients with all stages of fibrosis (F0-F3), compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), liver transplant (LT), post-LT and death. A 1-year model cycle length was considered, with each patient passing through the stages and exiting the model when reached one of mortality states. Transition probabilities and annual cost related to health states were derived from published literature. Moreover, the model made it possible to develop a scenario analysis to simulate the impact of treatments capable of slowing the disease progression in phases F0-F4 (CC). The results highlighted an economic burden of NASH in T2DM patients of approximately € 1.4 billion, € 3.1 billion, and € 9.4 billion, respectively, after 3, 5 and 10 years, reaching about € 17.3 billion after 15 years. The slowing down of the progression in the early stages of the disease (fibrosis F0-CC) has led to significant savings corresponding to € 2.3 billion at 15 years. These savings were generated by the reduction of the patients in the advanced stages of the disease, which is linked to a reduction in deaths, equal to 92,208 deaths avoided over a 15-year time horizon. Patients with NASH and T2DM reported an important burden in Italy. It is important to investigate the potential clinical and economic benefits of antidiabetic drugs that have been shown to be effective in preventing the transition to advanced disease, simultaneously acting on the therapeutic goals of diabetic disease.
Sections du résumé
Background
UNASSIGNED
Aim of our study is to evaluate the economic impact of NASH among diabetic population in Italy and potential benefits of treatments that can slow the disease progression.
Methods
UNASSIGNED
A Markov model was conducted from the Italian National Healthcare System perspective reporting results at 3, 5, 10 and 15 years. The model included NASH and T2DM patients with all stages of fibrosis (F0-F3), compensated cirrhosis (CC), decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), liver transplant (LT), post-LT and death. A 1-year model cycle length was considered, with each patient passing through the stages and exiting the model when reached one of mortality states. Transition probabilities and annual cost related to health states were derived from published literature. Moreover, the model made it possible to develop a scenario analysis to simulate the impact of treatments capable of slowing the disease progression in phases F0-F4 (CC).
Results
UNASSIGNED
The results highlighted an economic burden of NASH in T2DM patients of approximately € 1.4 billion, € 3.1 billion, and € 9.4 billion, respectively, after 3, 5 and 10 years, reaching about € 17.3 billion after 15 years. The slowing down of the progression in the early stages of the disease (fibrosis F0-CC) has led to significant savings corresponding to € 2.3 billion at 15 years. These savings were generated by the reduction of the patients in the advanced stages of the disease, which is linked to a reduction in deaths, equal to 92,208 deaths avoided over a 15-year time horizon.
Conclusion
UNASSIGNED
Patients with NASH and T2DM reported an important burden in Italy. It is important to investigate the potential clinical and economic benefits of antidiabetic drugs that have been shown to be effective in preventing the transition to advanced disease, simultaneously acting on the therapeutic goals of diabetic disease.
Identifiants
pubmed: 36127889
doi: 10.2147/CEOR.S371778
pii: 371778
pmc: PMC9482784
doi:
Types de publication
Journal Article
Langues
eng
Pagination
607-618Informations de copyright
© 2022 Torre et al.
Déclaration de conflit d'intérêts
This study was funded by unconditional and exclusive grant from NovoNordisk, Italy. The authors report no other conflicts of interest in this work.
Références
Hepatology. 2016 Jul;64(1):73-84
pubmed: 26707365
Hepatology. 2015 Dec;62(6):1723-30
pubmed: 26274335
Hepatology. 2018 Jan;67(1):328-357
pubmed: 28714183
J Hepatol. 2019 Oct;71(4):793-801
pubmed: 31279902
Diabetes Care. 2020 Feb;43(2):283-289
pubmed: 31658974
N Engl J Med. 2021 Mar 25;384(12):1113-1124
pubmed: 33185364
Value Health. 2013 Mar-Apr;16(2):231-50
pubmed: 23538175
Gastroenterology. 2005 Jul;129(1):113-21
pubmed: 16012941
J Gastroenterol Hepatol. 2019 Nov;34(11):2011-2018
pubmed: 31115065
Medicine (Baltimore). 2017 Sep;96(39):e8179
pubmed: 28953675
Diabetes Care. 2017 Mar;40(3):419-430
pubmed: 28223446
Gastroenterology. 2004 Feb;126(2):460-8
pubmed: 14762783
Clin Gastroenterol Hepatol. 2004 Mar;2(3):262-5
pubmed: 15017611
Liver Int. 2020 Feb;40 Suppl 1:82-88
pubmed: 32077613
Clin Gastroenterol Hepatol. 2011 Jun;9(6):524-530.e1; quiz e60
pubmed: 21440669
JHEP Rep. 2020 Jul 15;2(5):100142
pubmed: 32775976
Clin Gastroenterol Hepatol. 2009 Nov;7(11):1224-9, 1229.e1-2
pubmed: 19559819
Eur Rev Med Pharmacol Sci. 2021 Jul;25(13):4490-4498
pubmed: 34286491
Hepatology. 1996 Aug;24(2):289-93
pubmed: 8690394
Transplantation. 2003 May 27;75(10):1731-6
pubmed: 12777864
J Hepatol. 2018 Oct;69(4):896-904
pubmed: 29886156
Curr Med Res Opin. 2021 Nov;37(11):1867-1873
pubmed: 34357836
Frontline Gastroenterol. 2014 Jul;5(3):211-218
pubmed: 25018867
Nutr Metab Cardiovasc Dis. 2020 Jun 9;30(6):1014-1022
pubmed: 32423665