ORCID Profile
0000-0001-6331-0602
Current Organisation
University of Oxford
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Publisher: Elsevier BV
Date: 04-2023
Publisher: Springer Science and Business Media LLC
Date: 22-03-2021
DOI: 10.1007/S10198-020-01256-Y
Abstract: Non-alcoholic steatohepatitis (NASH) – a progressive subset of non-alcoholic fatty liver disease (NAFLD) – is a chronic liver disease that can progress to advanced fibrosis, cirrhosis, and end-stage liver disease (ESLD) if left untreated. Early-stage NASH is usually asymptomatic, meaning a large proportion of the prevalent population are undiagnosed. Receiving a NASH diagnosis increases the probability that a patient will receive interventions for the purpose of managing their condition. The purpose of this study was to estimate the disease burden and economic impact of diagnosed NASH in the United Kingdom (UK) adult population in 2018. The socioeconomic burden of diagnosed NASH from a societal perspective was estimated using cost-of-illness methodology applying a prevalence approach. This involved estimating the number of adults with diagnosed NASH in the UK in a base period (2018) and the economic and wellbeing costs attributable to diagnosed NASH in that period. The analysis was based on a targeted review of the scientific literature, existing databases and consultation with clinical experts, health economists and patient groups. Of the prevalent NASH population in the UK in 2018, an estimated 79.8% were not diagnosed. In particular, of the prevalent population in disease stages F0 to F2, only 2.0% (F0), 2.0% (F1) and 16.5% (F2), respectively, were diagnosed. Total economic costs of diagnosed NASH in the UK ranged from £2.3 billion (lower prevalence scenario, base probability of diagnosis scenario) to £4.2 billion (higher prevalence scenario, base probability of diagnosis scenario). In 2018, people with NASH in the UK were estimated to experience 94,094 to 174,564 disability-adjusted life years (DALYs) overall. Total wellbeing costs associated with NASH in 2018 were estimated to range between £5.6 to £10.5 billion. The prevention and appropriate management of adult NASH patients could result in reduced economic costs and improvements in wellbeing.
Publisher: Cold Spring Harbor Laboratory
Date: 04-06-2021
DOI: 10.1101/2021.06.03.21258279
Abstract: Angelman syndrome (AS) is a rare genetic condition characterised by global developmental delay, including severe to profound intellectual disability. The parents of persons with AS experience increased stress, anxiety and depression. This impacts parents’ career choices and productivity. To estimate, for the first time, the total productivity lost by the parents of persons with AS over a 10-year period in Australia and the corresponding cost to society. A cost-of-illness model with simulated follow-up over a 10-year period was developed, with 2019 as the baseline year, facilitated by a Markov chain of life tables. The prevalence of persons with AS and their parents, the productivity-adjusted life years (PALYs) lost by parents, and the cost to society were estimated. Key data were obtained from a prospective cohort of AS families, peer-reviewed literature, and publicly available sources. The base-case productivity burden borne by the estimated 330 living parents of the 428 prevalent-persons with AS totalled AUD$45.30 million, corresponding to a loss of 38.42% of PALYs per-parent. Caring for a child with AS has a significant impact on the productivity of affected parents, with a large associated impact on the broader Australian economy. Persons with AS require lifelong care and support. Consequently, AS results in a significant socioeconomic impact, borne both by the healthcare system and affected families. This is the first known study to estimate the total impact of caring for a child with AS on parental productivity, as well as the first study known to estimate the PALYs lost by a parental or caregiver population. This study found that caring for a child with AS has a significant impact on the productivity of affected parents, with a large associated impact on the broader Australian economy. At present, the supports available to persons with AS and their families include sleep aids and behavioural therapy. In future, specific therapeutic treatments for AS may become available, with trials underway at present investigating the efficacy and effectiveness of gene therapies for AS. As such, evidence regarding the total socioeconomic impact, including the parental productivity burden, attributable to AS is needed to inform future funding decisions.
Publisher: Wiley
Date: 18-03-2021
DOI: 10.1111/LIV.14825
Abstract: Non‐alcoholic steatohepatitis (NASH) is a chronic disease that can progress to end‐stage liver disease (ESLD). A large proportion of early‐stage NASH patients remain undiagnosed compared to those with advanced fibrosis, who are more likely to receive disease management interventions. This study estimated the disease burden and economic impact of diagnosed NASH in the adult population of France, Germany, Italy, Spain and the United Kingdom in 2018. The socioeconomic burden of diagnosed NASH was estimated using cost‐of‐illness methodology applying a prevalence approach to estimate the number of adults with NASH and the attributable economic and wellbeing costs. Given undiagnosed patients do not incur costs in the study, the probability of diagnosis is central to cost estimation. The analysis was based on a literature review, databases and consultation with clinical experts, economists and patient groups. The proportion of adult NASH patients with a diagnosis ranged from 11.9% to 12.7% across countries, which increased to 38.8%‐39.1% for advanced fibrosis (F3‐F4 compensated cirrhosis). Total economic costs were €8548‐19 546M. Of these, health system costs were €619‐1292M. Total wellbeing costs were €41 536‐90 379M. The majority of the undiagnosed population (87.3%‐88.2% of total prevalence) was found to have early‐stage NASH, which, left untreated, may progress to more resource consuming ESLD over time. This study found that the majority of economic and wellbeing costs of NASH are experienced in late disease stages. Earlier diagnosis and care of NASH patients could reduce future healthcare costs.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Sally Hartmanis.