Abstract
Objective: The aim of this study was to evaluate the healthcare economic burden of nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH) who progress to liver cirrhosis (LC) and hepatocellular carcinoma (HCC) in Japan. Method: A retrospective study using the Japan Medical Data Center (JMDC) claims database which include data between 2005 and 2019, with a total of 185,121 patients enrolled, and 136,718 patients meeting the criteria for NAFLD/NASH, with 313 patients progressing to LC, and 146 patients progressing to HCC. The healthcare costs were calculated based on inpatient, outpatient, and pharmacy claims evaluated independently at NAFLD/NASH, LC, and HCC diagnosis. Result: Total all-cause healthcare costs per patient per month (PPPM) after diagnosis was lowest in the NAFLD/NASH cohort at ¥134,143, with ¥268,033 for LC (p<0.0001) and ¥345,156 for HCC (p<0.0001) being significantly higher. In addition, the post-diagnosis and pre-diagnosis costs are statistically different across each liver disease severity stage. Conclusion: This is the first study that has analyzed current cost burden in NAFLD and NASH patients in Japan from an administrative real-world claims database, which demonstrated the progression of advanced liver disease stages in NAFLD or NASH patients represents a significant economic burden.
