Table 4.

Direct per patient costs associated with NASH

Study	Country	Currency, ref year	Population	N	Total direct costs	Medical costs
Cirrhosis-related costs
Axley et al. [27]	US	USD, NR	Hospital admissions for cirrhosis with ACLF (2006–2014)	112,174	NR	Total hospital charges/patient: • NASH-related: $151,196 • Alcohol-related: $97,492 • Viral hepatitis-related: $117,016 • Other aetiologies: $140,279 • Overall non-NASH-related: $134,597 (p < 0.0001 vs NASH-related)
			NASH-related  Alcohol-related  Viral hepatitis-related  Other aetiologies	8903 27,890 9491 65,890
			Hospital admissions for CC (2006–2014)	1,358,275	NR	Median total hospital charges/admission: • NASH-related: $143,258 • Alcohol-related: $97,472 • Viral hepatitis-related: $117,016
			NASH-related  Alcohol-related  Viral hepatitis-related	699,668 NR NR
NASH-related costs with or without comorbidities
O’Hara et al. [30]	US and EU5a	Euros, 2019	NASH	Total: 3754 Early (F0–2): 2604 (69%) Advanced (F3–4): 1150 (31%) Germany: 540 Spain: 522 France: 508 UK: 423 Italy: 540 US: 1221	Total annual costs PP, mean (SD): • Overall: €4754 (22,117) • F0–2 vs F3–4: €3883 (20,634) vs €6727 (25,052) • DE: €3629 (8795); ES: €3323 (11,258); FR: €2440 (6241); UK: €3879 (3811); IT: €2739 (8296); US: €7258 (36,704) NASH-related annual costs PP, mean (SD): • Overall: €2763 (21,216) • F0–2 vs F3–4: €2224 (19,956) vs €3983 (23,788) • DE: €1917 (7715); ES: €2162 (10,220); FR: €1357 (5427); UK: €1851 (2406); IT: €1732 (7799); US: €4881 (42,077) Non-NASH annual costs PP, mean (SD): • Overall: €1991 (4840) • F0–2 vs F3–4: €1659 (4117) vs €2743 (6107) • DE: €1712 (3698); ES: €1161 (3200); FR: €1082 (2234); UK: €2027 (2897); IT: €1006 (2397); US: €2957 (7170)	Test/procedure annual costs PP, mean (SD): • Overall: 283 (486) • F0–2 vs F3–4: 265 (439) vs 323 (575) • DE: €183 (221); ES: €168 (180); FR: €124 (117); UK: €415 (668); IT: €220 (448); US: €435 (726) NASH treatment annual costs PP, mean (SD): • Overall: 1106 (3877) • F0–2 vs F3–4: 989 (3596) vs 1373 (4438) • DE: €655 (2218); ES: €739 (3047); FR: €502 (1292); UK: €624 (1550); IT: €431 (1718); US: €2241 (6743) Surgery annual costs PP, mean (SD): • Overall: 915 (20,512) • F0–2 vs F3–4: 653 (19,609) vs 1507 (22,420) • DE: €848 (6740); ES: €735 (8197); FR: €228 (4590); UK: €103 (1141); IT: €573 (7113); US: €1582 (34,825) Consultation annual costs PP, mean (SD): • Overall: 264 (314) • F0–2 vs F3–4: 259 (298) vs 274 (348) • DE: €89 (90); ES: €300 (312); FR: €203 (197); UK: €665 (487); IT: €275 (224); US: €210 (291)
						Hospitalisation annual costs PP, mean (SD): • Overall: 195 (2094) • F0–2 vs F3–4: 58 (815) vs 507 (3561) • DE: €143 (967); ES: €219 (2203); FR: €300 (1669); UK: €56 (443); IT: €233 (1232); US: €201 (3420) Non-medical annual costs PPb, mean (SD): • Overall (n=767): 2556 (7308) • F0–2 (n=546) vs F3–4 (n=221): 1704 (5785) vs 4661 (9839) • DE (n=132): €2695 (7273); ES (n=169): €4713 (10,828); FR (n=130): €213 (920); UK (n=20): €2063 (3707); IT (n=219): €1977 (5515); US (n=97): €3243 (7685)
Reja et al. [31]	US	USD, 2016 (Payer)	Hospitalised NASH patients with or without kidney failure, 2016	Total: 1196 With kidney failure: 598 Without kidney failure: 598	NR	Total charge of hospitalisation, mean (SD): • Overall: $58,023.7 (116,290.8) • With vs without kidney failure: $78,022.7 (158,580.8) vs $38,024.8 (33,476.0). β/OR = 37,045.9 (95% CI 31,756.18–42,335.62; p < 0.0001)

^aEU5 includes France, Germany, Italy, Spain and the UK

^bProfessional (34%) and informal (48%) caregivers account for most non-medical costs. Other costs resulted from transport, disability allowances, alternative therapies, home alteration and OTC remedies

ACLF acute-on-chronic liver failure, CC compensated cirrhosis, CI confidence interval, DE German cohort, ES Spanish cohort, F0–4 fibrosis stages 0–4, FR French cohort, IT Italian cohort, NASH non-alcoholic steatohepatitis, NR not reported, OR odds ratio, OTC over-the-counter, PP per patient, SD standard deviation, UK UK cohort, US US cohort, USD US dollars