Substantial healthcare utilization (HCU) and costs among nonalcoholic steatohepatitis (NASH) patients with comorbid diabetes mellitus (DM): Real-world analysis of 2007-2015 US medicare data.

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Conference Proceeding

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Hepatol Int


Introduction/Objectives: This study aimed to evaluate the impact of concurrent DM on HCU and costs among NASH patients with CC. Method: NASH/Non-Alcoholic Fatty Liver Disease (NAFLD) patients with CC aged ≥18 years were extracted from 2007 to 2015 US Medicare 20% sample data via ICD codes. Index date was first CC diagnosis. Other liver diseases were excluded. Comorbidities were defined during 6 months pre-index period (pre). HCU and costs were analyzed during 6 months pre- and post-index period (post), and adjusted to per patient (PP) annual values in 2015 USD. Results: 3775 NASH/NAFLD CC patients with mean age 67.0 (± 10.9) years and 63.3% females were included. More than 98% had ≥1 comorbidities: DM (74.8%), hyperlipidemia (91.6%), and hypertension (93.9%). Annual mean visits (inpatient/outpatient/ physician) for CC cohort were 33.9 (pre) vs. 40.7 (post) (p<0.001). Total costs for CC cohort was $19,385 (pre) vs. $33,504 (post) (p<0.001). Comorbidity burden was high in both CC DM patients and CC non-DM patients: hypertension 97.1% (DM) and 84.7% (non-DM); hyperlipidemia 95.3% (DM) and 80.7% (non-DM). For CC DM patients, mean inpatient visits were 0.52 (pre) vs. 0.99 (post) (p<0.001), and for CC non-DM patients, mean inpatient visits were 0.37 (pre) vs. 0.76 (post) (p<0.001). The total costs for CC DM patients were $20,646 (pre) vs. $35,359 (post) (p<0.001), and for CC non-DM patients were $15,633 (pre) vs. $27,953 (post) (p<0.001). Conclusion: Medicare patients with NASH/NAFLD and CC with/ without DM reported a high comorbidity and HCU burden, suggesting early identification and effective treatment is needed. (Figure Presented) .




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