Economic burden of non-alcoholic steatohepatitis with significant fibrosis in Thailand

BMC Gastroenterology

Nathorn Chaiyakunapruk¹  Ratthanon Prasitwarachot²  Chayanis Kositamongkol³  Weerachai Srivanichakorn³  Chaiwat Washirasaksiri³  Pochamana Phisalprapa³  Phunchai Charatcharoenwitthaya⁴  Sombat Treeprasertsuk⁵  Pranaidej Hengswat⁶ 

[1] Department of Pharmacotherapy, College of Pharmacy, University of Utah, 84112, Salt Lake City, UT, USA;Department of Pharmacy Technicians, Sirindhorn College of Public Health Suphanburi, Suphanburi, Thailand;Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand;Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand;Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok, Thailand;Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand;

关键词: Non-alcoholic steatohepatitis;    NASH;    Significant fibrosis;    Economic burden;    Cost of illness;    Prevalence;    Thailand;   

DOI  :  10.1186/s12876-021-01720-w

来源: Springer

【 摘 要 】

BackgroundNon-alcoholic steatohepatitis (NASH) has been recognised as a significant form of chronic liver disease and a common cause of cirrhosis and hepatocellular carcinoma, resulting in a considerable financial burden on healthcare resources. Currently, there is no information regarding the economic burden of NASH in low- and middle-income countries (LMICs). The aim of this study was to estimate the economic burden of NASH in Thailand as a lesson learned for LMICs.MethodsTo estimate the healthcare costs and prevalence of NASH with significant fibrosis (fibrosis stage ≥ 2) in the general Thai population, an eleven-state lifetime horizon Markov model with 1-year cycle length was performed. The model comprised Thai population aged 18 years and older. The cohort size was based on Thailand Official Statistic Registration Systems. The incidence of NASH, transitional probabilities, and costs-of-illness were based on previously published literature, including systematic reviews and meta-analyses. The age-specific prevalence of NASH was based on Thai NASH registry data. Costs were expressed in 2019 US Dollars ($). As we undertook analysis from the payer perspective, only direct medical costs were included. All future costs were discounted at an annual rate of 3%. A series of sensitivity analyses were performed.ResultsThe estimated total number of patients with significant NASH was 2.9 million cases in 2019, based on a NASH prevalence of 5.74%. The total lifetime cost of significant NASH was $15.2 billion ($5,147 per case), representing approximately 3% of the 2019 GDP of Thailand. The probabilistic sensitivity analysis showed that the lifetime costs of significant NASH varied from $11.4 billion to $18.2 billion.ConclusionsThe economic burden associated with NASH is substantial in Thailand. This prompts clinicians and policy makers to consider strategies for NASH prevention and management.

【 授权许可】

CC BY