1253-P: High Health-Care Utilization (HCU) and Costs Associated with Diabetes Mellitus (DM) and Nonalcoholic Fatty Liver Disease/Nonalcoholic Steatohepatitis (NAFLD/NASH) in Medicare Patients

Abstract

Background: One of the common comorbidities in NAFLD/NASH patients is DM. This study evaluated HCU and costs in NAFLD/NASH patients with varying liver disease severity by DM status. Methods: This was a retrospective study from 2007-2015 of a 20% sample of U.S. Medicare beneficiaries and included NAFLD/NASH patients (ICD codes) with and without DM (ICD codes/medications). Mean annual healthcare costs were reported in 2015 USD and stratified by NAFLD/NASH only, compensated cirrhosis (CC), decompensated cirrhosis (DCC), liver transplant (LT), and hepatocellular carcinoma (HCC) and presence of DM. Results: This study identified 260,950 NAFLD/NASH patients, of which 144,862 (55.5%) also had comorbid DM. NAFLD/NASH CC patients with DM had high rates of additional metabolic comorbidities: 77.5% with cardiovascular disease and 87.5% with both hypertension and hyperlipidemia. Mean annual number of hospitalizations in NAFLD/NASH only with DM was 0.6, which significantly increased in CC (0.8) and DCC (2.2) DM patients. Mean annual healthcare costs were significantly higher in those with comorbid DM (except HCC) (Figure). Conclusions: Comorbid DM among NAFLD/NASH patients is associated with high metabolic comorbidity burden and significantly higher HCU and healthcare costs in U.S. Medicare patients. Disclosure S. Gordon: Consultant; Self; Gilead Sciences, Inc., Intercept Pharmaceuticals, Inc. J. Fraysse: Employee; Self; Gilead Sciences, Inc. S. Li: Consultant; Self; Gilead Sciences, Inc. A. Ozbay: Employee; Self; Gilead Sciences, Inc. Stock/Shareholder; Self; Gilead Sciences, Inc. R. Wong: Advisory Panel; Self; Gilead Sciences, Inc. Consultant; Self; Gilead Sciences, Inc. Research Support; Self; Gilead Sciences, Inc. Speaker's Bureau; Self; Gilead Sciences, Inc.