Cost of non-alcoholic steatohepatitis in Europe and the USA: The GAIN study
Background & Aims: Non-alcoholic steatohepatitis (NASH) leads to cirrhosis and is associated with a substantial socioeconomic burden, which, coupled with rising prevalence, is a growing public health challenge. However, there are few real-world data available describing the impact of NASH. M...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-10-01
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| Series: | JHEP Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589555920300768 |
| _version_ | 1811293131640930304 |
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| author | Jamie O'Hara Alan Finnegan Harpal Dhillon Leonardo Ruiz-Casas Gabriel Pedra Bethany Franks George Morgan Vanessa Hebditch Bengt Jönsson Mzwandile Mabhala Tatjana Reic Ingo Van Thiel Vlad Ratziu Manuel Romero-Gomez Elisabetta Bugianesi Jörn M. Schattenberg Quentin M. Anstee |
| author_facet | Jamie O'Hara Alan Finnegan Harpal Dhillon Leonardo Ruiz-Casas Gabriel Pedra Bethany Franks George Morgan Vanessa Hebditch Bengt Jönsson Mzwandile Mabhala Tatjana Reic Ingo Van Thiel Vlad Ratziu Manuel Romero-Gomez Elisabetta Bugianesi Jörn M. Schattenberg Quentin M. Anstee |
| author_sort | Jamie O'Hara |
| collection | DOAJ |
| description | Background & Aims: Non-alcoholic steatohepatitis (NASH) leads to cirrhosis and is associated with a substantial socioeconomic burden, which, coupled with rising prevalence, is a growing public health challenge. However, there are few real-world data available describing the impact of NASH. Methods: The Global Assessment of the Impact of NASH (GAIN) study is a prevalence-based burden of illness study across Europe (France, Germany, Italy, Spain, and the UK) and the USA. Physicians provided demographic, clinical, and economic patient information via an online survey. In total, 3,754 patients found to have NASH on liver biopsy were stratified by fibrosis score and by biomarkers as either early or advanced fibrosis. Per-patient costs were estimated using national unit price data and extrapolated to the population level to calculate the economic burden. Of the patients, 767 (20%) provided information on indirect costs and health-related quality of life using the EuroQOL 5-D (EQ-5D; n = 749) and Chronic Liver Disease Questionnaire – Non-Alcoholic Fatty Liver Disease (CLDQ-NAFLD) (n = 723). Results: Mean EQ-5D and CLDQ-NAFLD index scores were 0.75 and 4.9, respectively. For 2018, the mean total annual per patient cost of NASH was €2,763, €4,917, and €5,509 for direct medical, direct non-medical, and indirect costs, respectively. National per-patient cost was highest in the USA and lowest in France. Costs increased with fibrosis and decompensation, driven by hospitalisation and comorbidities. Indirect costs were driven by work loss. Conclusions: The GAIN study provides real-world data on the direct medical, direct non-medical, and indirect costs associated with NASH, including patient-reported outcomes in Europe and the USA, showing a substantial burden on health services and individuals. Lay summary: There has been little research into the socioeconomic burden associated with non-alcoholic steatohepatitis (NASH). The GAIN study provides real-world data on the direct medical, direct non-medical, and indirect costs associated with NASH, including patient-reported outcomes in five European countries (UK, France, Germany, Spain, and Italy) and the USA. Mean total annual per patient cost of NASH was estimated at €2,763, €4,917, and €5,509 for the direct medical, direct non-medical, and indirect cost categories, respectively. |
| first_indexed | 2024-04-13T04:56:00Z |
| format | Article |
| id | doaj.art-442840db6e7b4fcfafbe49ed134527fb |
| institution | Directory Open Access Journal |
| issn | 2589-5559 |
| language | English |
| last_indexed | 2024-04-13T04:56:00Z |
| publishDate | 2020-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHEP Reports |
| spelling | doaj.art-442840db6e7b4fcfafbe49ed134527fb2022-12-22T03:01:28ZengElsevierJHEP Reports2589-55592020-10-0125100142Cost of non-alcoholic steatohepatitis in Europe and the USA: The GAIN studyJamie O'Hara0Alan Finnegan1Harpal Dhillon2Leonardo Ruiz-Casas3Gabriel Pedra4Bethany Franks5George Morgan6Vanessa Hebditch7Bengt Jönsson8Mzwandile Mabhala9Tatjana Reic10Ingo Van Thiel11Vlad Ratziu12Manuel Romero-Gomez13Elisabetta Bugianesi14Jörn M. Schattenberg15Quentin M. Anstee16Faculty of Health and Social Care, University of Chester, Chester, UKFaculty of Health and Social Care, University of Chester, Chester, UKHCD Economics, Daresbury, UKHCD Economics, Madrid, SpainHCD Economics, Daresbury, UKHCD Economics, Daresbury, UK; Corresponding author. Address: HCD Economics, The Innovation Centre, Keckwick Lane, Daresbury, WA4 4FS, UK. Tel.: + 44 19 25 60 64 75.HCD Economics, Daresbury, UKBritish Liver Trust, Bournemouth, UKStockholm School of Economics, Stockholm, SwedenFaculty of Health and Social Care, University of Chester, Chester, UKCroatian Association for Liver Diseases (Hepatos), Split, CroatiaDeutsche Leberhilfe, Köln, GermanySorbonne University, Paris, FranceUniversity of Seville, Seville, SpainUniversity of Turin, Turin, ItalyMetabolic Liver Research Program I, Department of Medicine, University Medical Center Main, Mainz, GermanyInstitute of Translational and Clinical Research, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, UKBackground & Aims: Non-alcoholic steatohepatitis (NASH) leads to cirrhosis and is associated with a substantial socioeconomic burden, which, coupled with rising prevalence, is a growing public health challenge. However, there are few real-world data available describing the impact of NASH. Methods: The Global Assessment of the Impact of NASH (GAIN) study is a prevalence-based burden of illness study across Europe (France, Germany, Italy, Spain, and the UK) and the USA. Physicians provided demographic, clinical, and economic patient information via an online survey. In total, 3,754 patients found to have NASH on liver biopsy were stratified by fibrosis score and by biomarkers as either early or advanced fibrosis. Per-patient costs were estimated using national unit price data and extrapolated to the population level to calculate the economic burden. Of the patients, 767 (20%) provided information on indirect costs and health-related quality of life using the EuroQOL 5-D (EQ-5D; n = 749) and Chronic Liver Disease Questionnaire – Non-Alcoholic Fatty Liver Disease (CLDQ-NAFLD) (n = 723). Results: Mean EQ-5D and CLDQ-NAFLD index scores were 0.75 and 4.9, respectively. For 2018, the mean total annual per patient cost of NASH was €2,763, €4,917, and €5,509 for direct medical, direct non-medical, and indirect costs, respectively. National per-patient cost was highest in the USA and lowest in France. Costs increased with fibrosis and decompensation, driven by hospitalisation and comorbidities. Indirect costs were driven by work loss. Conclusions: The GAIN study provides real-world data on the direct medical, direct non-medical, and indirect costs associated with NASH, including patient-reported outcomes in Europe and the USA, showing a substantial burden on health services and individuals. Lay summary: There has been little research into the socioeconomic burden associated with non-alcoholic steatohepatitis (NASH). The GAIN study provides real-world data on the direct medical, direct non-medical, and indirect costs associated with NASH, including patient-reported outcomes in five European countries (UK, France, Germany, Spain, and Italy) and the USA. Mean total annual per patient cost of NASH was estimated at €2,763, €4,917, and €5,509 for the direct medical, direct non-medical, and indirect cost categories, respectively.http://www.sciencedirect.com/science/article/pii/S2589555920300768Non-alcoholic steatohepatitisCost of illnessCross-sectional studiesEurope |
| spellingShingle | Jamie O'Hara Alan Finnegan Harpal Dhillon Leonardo Ruiz-Casas Gabriel Pedra Bethany Franks George Morgan Vanessa Hebditch Bengt Jönsson Mzwandile Mabhala Tatjana Reic Ingo Van Thiel Vlad Ratziu Manuel Romero-Gomez Elisabetta Bugianesi Jörn M. Schattenberg Quentin M. Anstee Cost of non-alcoholic steatohepatitis in Europe and the USA: The GAIN study JHEP Reports Non-alcoholic steatohepatitis Cost of illness Cross-sectional studies Europe |
| title | Cost of non-alcoholic steatohepatitis in Europe and the USA: The GAIN study |
| title_full | Cost of non-alcoholic steatohepatitis in Europe and the USA: The GAIN study |
| title_fullStr | Cost of non-alcoholic steatohepatitis in Europe and the USA: The GAIN study |
| title_full_unstemmed | Cost of non-alcoholic steatohepatitis in Europe and the USA: The GAIN study |
| title_short | Cost of non-alcoholic steatohepatitis in Europe and the USA: The GAIN study |
| title_sort | cost of non alcoholic steatohepatitis in europe and the usa the gain study |
| topic | Non-alcoholic steatohepatitis Cost of illness Cross-sectional studies Europe |
| url | http://www.sciencedirect.com/science/article/pii/S2589555920300768 |
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