PMID- 31919793
OWN - NLM
STAT- MEDLINE
DCOM- 20210401
LR  - 20210401
IS  - 1179-2027 (Electronic)
IS  - 1170-7690 (Linking)
VI  - 38
IP  - 5
DP  - 2020 May
TI  - Systematic Literature Review and Critical Appraisal of Health Economic Models 
      Used in Cost-Effectiveness Analyses in Non-Alcoholic Steatohepatitis: Potential 
      for Improvements.
PG  - 485-497
LID - 10.1007/s40273-019-00881-7 [doi]
AB  - BACKGROUND: Non-alcoholic steatohepatitis (NASH) is a severe, typically 
      progressive form of non-alcoholic fatty liver disease (NAFLD). The global 
      prevalence of NASH is increasing, driven partly by the global increase in obesity 
      and type 2 diabetes mellitus (T2DM), such that NASH is now a leading cause of 
      cirrhosis. There is currently an unmet clinical need for efficacious and 
      cost-effective treatments for NASH; no pharmacologic agents have an approved 
      indication for NASH. OBJECTIVE: Our objective was to summarise and critically 
      appraise published health economic models of NASH, to evaluate their quality and 
      suitability for use in the assessment of novel treatments for NASH, and to 
      identify knowledge gaps, challenges and opportunities for future modelling. 
      METHODS: A systematic literature review was performed using the MEDLINE, Embase, 
      Cochrane Library and EconLit databases to identify published health economic 
      analyses in patients with NAFLD or NASH. Supplementary hand searches of grey 
      literature were also performed. Articles published up to November 2019 were 
      included in the review. Quality assessment of identified studies was also 
      performed. RESULTS: A total of 19 articles comprising 16 unique models including 
      either NAFLD as a whole or NASH alone were included in the review. Structurally, 
      most models had a state-transition component; in terms of health states, two 
      different approaches to early disease states were used, modelling either 
      progression through fibrosis stages or NAFLD/NASH-specific health states. 
      Conditions that frequently co-exist with NASH, such as obesity, T2DM and 
      cardiovascular disease were not captured in models identified here. Late-stage 
      complications such as cirrhosis, decompensated cirrhosis and hepatocellular 
      carcinoma were consistently included, but input data (e.g. costs, utilities and 
      transition probabilities) for late-stage complications were frequently sourced 
      from other liver disease areas. The quality of included studies was heterogenous, 
      and only a small proportion of studies reported internal and external validation 
      processes. CONCLUSION: The health economic models identified in this review are 
      associated with limitations primarily driven by a lack of NASH-specific data. 
      Identified models also largely overlooked the intricate association between NASH 
      and other conditions, including obesity and T2DM, and did not capture the 
      increased risk of cardiovascular events associated with NASH. High-quality, 
      transparent, validated health economic models of NASH will be required to 
      evaluate the cost effectiveness of treatments currently in development, 
      particularly compounds that may target other non-hepatic outcomes.
FAU - Johansen, Pierre
AU  - Johansen P
AUID- ORCID: 0000-0002-6287-7508
AD  - Novo Nordisk A/S, Soborg, Denmark. pirj@novonordisk.com.
FAU - Howard, Daniel
AU  - Howard D
AD  - DRG Abacus, Manchester, UK.
FAU - Bishop, Ryan
AU  - Bishop R
AD  - DRG Abacus, Bicester, UK.
FAU - Moreno, Soren Ilsoe
AU  - Moreno SI
AD  - Novo Nordisk A/S, Soborg, Denmark.
FAU - Buchholtz, Kristine
AU  - Buchholtz K
AD  - Novo Nordisk A/S, Soborg, Denmark.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
PL  - New Zealand
TA  - Pharmacoeconomics
JT  - PharmacoEconomics
JID - 9212404
CIN - Pharmacoeconomics. 2020 May;38(5):427-429. PMID: 32086769
MH  - *Cost-Benefit Analysis
MH  - Fatty Liver/*drug therapy/*economics
MH  - Humans
MH  - *Models, Economic
MH  - Non-alcoholic Fatty Liver Disease/*drug therapy/*economics
MH  - Treatment Outcome
EDAT- 2020/01/11 06:00
MHDA- 2021/04/02 06:00
CRDT- 2020/01/11 06:00
PHST- 2020/01/11 06:00 [pubmed]
PHST- 2021/04/02 06:00 [medline]
PHST- 2020/01/11 06:00 [entrez]
AID - 10.1007/s40273-019-00881-7 [pii]
AID - 10.1007/s40273-019-00881-7 [doi]
PST - ppublish
SO  - Pharmacoeconomics. 2020 May;38(5):485-497. doi: 10.1007/s40273-019-00881-7.