(389) Healthcare Resource Utilization and Costs in Patients with Metabolic Dysfunction Associated Steatohepatitis: A Comparison Between Patients with Diagnosed MASH, Probable MASH, and Without MASH

Background: : There is a high economic burden associated with metabolic dysfunction-associated steatohepatitis (MASH). Most studies have reported on the healthcare resource utilization (HCRU) and costs in patients with diagnosed MASH. However, MASH is often underdiagnosed and the burden in this group is unknown.

Objective: : To compare HCRU and costs among patients with probable MASH, diagnosed MASH, and those without MASH.

Methods: : The study used Komodo Healthcare Map™ data (Jan 2017–Dec 2022) and identified patients with probable MASH via an adapted MASLD Decision Tree (hepatic steatosis index >36 or ICD-10-CM code K76.0) plus ≥1 cardiometabolic risk factor. Patients with diagnosed MASH required ≥1 primary inpatient or ≥2 outpatient codes (K75.81) ≥30 days apart. Patients without MASH met none of these criteria. Propensity score weighting adjusted for baseline differences. HCRU (inpatient [IP], outpatient [OP], emergency department [ED] visits, prescriptions) and associated costs were assessed for all-cause, major adverse liver outcomes (MALO)-related, and major adverse cardiovascular events (MACE)-related categories using weighted generalized linear or two-part models.

Results: : The study included patients with probable MASH (n=1,549,485), diagnosed MASH (n=15,000), and without MASH (n=513,862). Mean all-cause costs per patient per year (PPPY) were $18,562 for patients with probable MASH, compared to $14,611 for those without MASH and $26,624 for those with diagnosed MASH. The mean cost ratio (MCR) for probable MASH vs. without MASH was 1.27 (95% CI: 1.26–1.28). In contrast, the MCR for patients with probable MASH vs. diagnosed MASH was 0.70 (95% CI: 0.67–0.72). Patients with probable MASH incurred significantly higher all-cause IP ($3,406), OP ($9,490), and ED ($855) costs compared to those without MASH ($2,663, $8,088, and $666, respectively). Additionally, patients with diagnosed MASH had costs of $5,225, $13,196, and $1,150, respectively. The associated MCRs were IP: 1.28 (1.26, 1.29); OP: 1.17 (1.61, 1.87); and ED: 1.29 (1.27, 1.30) for patients with probable MASH vs. those without MASH. For patients with probable MASH vs. those with diagnosed MASH, the MCRs were IP: 0.65 (0.64, 0.66); OP: 0.72 (0.69, 0.75); and ED: 0.74 (0.74, 0.75), respectively. Comparable patterns were observed in MALO- and MACE-related costs, and HCRU.

Conclusions: : Patients with probable MASH show higher HCRU and costs than patients without MASH, but lower than patients with diagnosed MASH, highlighting the economic burden of MASH and the importance of early diagnosis and intervention.

Sponsorship:: Novo Nordisk Inc.