Out of all patients with NAFLD, around 20% develop non-alcoholic steatohepatitis, NASH. This condition is categorised by symptoms such as the progressive fibrosis of the liver, often followed with cirrhosis and liver failure. NAFLD and NASH are also highly associated with issues such as type 2 diabetes, obesity and hypertension. Overall, it is therefore estimated that patients in the United States with NASH total lifetime medical costs exceeding $223 billion. However, there is limited data surrounding the economic burden of this disease at earlier stages, such as at intermediate fibrosis. This study found that higher FIB-4 was associated with higher rates of comorbidities, which, in turn, correlated with higher healthcare needs and associated healthcare costs. With each one-unit increase in FIB-4 in patients, there was found to be a 3.4% increase in overall healthcare costs. This study highlights the need for early intervention to reduce healthcare costs for this vulnerable population.
This review by Tapper EB et al. aimed to understand the healthcare cost burden related to NAFLD and NASH in the United States.
Overall, FIB-4 scores demonstrate an increase in patient cost burden, supporting the need for early interventions in NAFLD and NASH. Even low FIB-4 scores demonstrate significant burdens of over $16,000 annually. However, there remain knowledge gaps surrounding fibrosis in its connection with cardiovascular diseases and body mass index.