Cost-Effectiveness of MASH Diagnosis and Management Approaches Among Those With Type 2 Diabetes
Rattachement africain : us, es, cl, Tanzanie, it, se, jp, Afrique du Sud, br, de, sa. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Importance: Metabolic dysfunction-associated steatohepatitis (MASH) represents a high, underprioritized burden among noncommunicable diseases (NCDs) and people living with type 2 diabetes (T2D). Objective: To identify cost-effective management approaches to prevent, detect, and treat MASH and liver fibrosis in people living with T2D. Design, Setting, and Participants: This economic evaluation consisted of a generalized cost-effectiveness analysis (GCEA) that was conducted for 12 countries (Brazil, Chile, Germany, Italy, Japan, Saudi Arabia, South Africa, Spain, Sweden, Tanzania, Thailand, and the United States), across all 6 World Health Organization (WHO) regions. A cohort state-transition model simulated liver disease development and its impact on a synthetic cohort, aged 19 years and older and living with T2D, over their lifespan across 10 liver health states. Exposures: Using an 80% coverage level, 14 management approaches were compared, including screening via the Fibrosis-4 (FIB-4) test and Enhanced Liver Fibrosis (ELF) test or vibration-controlled transient elastography (VCTE) as well as treatment with pharmacological and nonpharmacological interventions. Main Outcomes and Measures: The main outcomes were the average cost-effectiveness ratios (ACERs) and the incremental cost-effectiveness ratios (ICERs), which were used to construct care expansion paths by ranking the management approaches in order of cost-effectiveness. The main measures were the total incremental costs and the total incremental quality-adjusted life-years (QALYs) of each intervention. Results: In this GCEA, the outcomes were evaluated with respect to country-specific willingness-to-pay thresholds. The standard of care had the lowest ACERs in 8 countries (not in Chile, Germany, Saudi Arabia, or the United States). Treatment with intensive lifestyle interventions (ILIs), after screening via ELF or VCTE, was cost-effective in all countries. ILIs and treatment with semaglutide was cost-effective in 11 countries (not in Tanzania); ILIs and treatment with resmetirom was cost-effective in 8 countries (not in Brazil, South Africa, Tanzania, or Thailand). Conclusion and Relevance: In this economic evaluation, screening followed by ILIs was found to be a cost-effective management approach for MASH and liver fibrosis among people living with T2D in all countries. Screening followed by pharmacological treatment was cost-effective in most countries. These results can inform health policy decision-making and further the development of WHO recommended interventions to address NCDs.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Cost-Effectiveness of MASH Diagnosis and Management Approaches Among Those With Type 2 Diabetes
- Date Crossref
- 06/11/2025
- Éditeur
- American Medical Association (AMA)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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The Graduate Center pays non établi dans la noticeUniversité ou école supérieure
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City University of New York pays non établi dans la noticeUniversité ou école supérieure
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Barcelona Institute for Global Health pays non établi dans la noticeÉtablissement de santé
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CUNY Graduate School of Public Health and Health Policy pays non établi dans la noticeUniversité ou école supérieure
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Universitat de Barcelona pays non établi dans la noticeUniversité ou école supérieure
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Pontificia Universidad Católica de Chile pays non établi dans la noticeUniversité ou école supérieure
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University of California San Diego MASLD Research Center pays non établi dans la noticeUniversité ou école supérieure
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Texas Tech University Department of Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
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Texas Tech University Health Sciences Center pays non établi dans la noticeUniversité ou école supérieure
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National Institute for Medical Research Tanzanie (code pays fourni par la source)Structure de recherche
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Istituto Superiore di Sanità pays non établi dans la noticeOrganisme public
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Karolinska University Hospital Department of Upper GI Diseases pays non établi dans la noticeÉtablissement de santé
The Graduate Center, City University of New York et Barcelona Institute for Global Health, avec 9 autres affiliations. Pays d’affiliation : Tanzanie, Afrique du Sud.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.