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.

中文翻译：

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2018 年英国诊断出的非酒精性脂肪性肝炎 (NASH) 的疾病负担和经济影响

 背景和目标

非酒精性脂肪性肝炎 (NASH) 是非酒精性脂肪性肝病 (NAFLD) 的一种进行性亚型，是一种慢性肝病，如果不及时治疗，可能会进展为晚期纤维化、肝硬化和终末期肝病 (ESLD)。早期 NASH 通常是无症状的，这意味着很大一部分患病人群未被诊断出来。接受 NASH 诊断会增加患者接受干预措施以控制病情的可能性。本研究的目的是估计 2018 年英国 (UK) 成年人口中诊断出的 NASH 的疾病负担和经济影响。

 方法

从社会角度来看，诊断 NASH 的社会经济负担是使用患病率方法的疾病成本方法来估计的。这涉及估计基期（2018 年）英国诊断出 NASH 的成年人数量以及该时期诊断出 NASH 造成的经济和福祉成本。该分析基于对科学文献、现有数据库的有针对性的审查以及与临床专家、健康经济学家和患者团体的咨询。

 结果

2018 年英国 NASH 流行人群中，估计有 79.8% 的人未被诊断出来。特别是，在疾病阶段 F0 至 F2 的流行人群中，分别只有 2.0% (F0)、2.0% (F1) 和 16.5% (F2) 被诊断出来。在英国，确诊 NASH 的总经济成本从 23 亿英镑（较低患病率情景，诊断基本概率情景）到 42 亿英镑（较高患病率情景，诊断基本概率情景）不等。 2018 年，英国 NASH 患者预计总体经历 94,094 至 174,564 伤残调整生命年 (DALY)。 2018 年与 NASH 相关的总健康成本估计在 5.6 至 105 亿英镑之间。

 结论

成人 NASH 患者的预防和适当管理可以降低经济成本并改善福祉。