Characterizing the Prevalence of Metabolic Dysfunction-Associated Steatohepatitis (MASH) Among Adults ≥65 Years of Age in the United States (US) Using Three Real-World Cohorts
Author(s)
Kim Y1, Rochon H2, Qian C2, Szabo S2, Bogdanov A3, Zeng N4, Sun R2, Bonafede M3, Davis M5, Nunag D6, Fishman J7
1Madrigal Pharmaceuticals, Jersey City, NJ, USA, 2Broadstreet HEOR, Vancouver, BC, Canada, 3Veradigm, Chicago, IL, USA, 4Veradigm, Raleigh, NC, USA, 5Medicus Economics, Dover, MA, USA, 6Medicus Economics, Milton, MA, USA, 7Madrigal Pharmaceuticals, West Conshohocken, PA, USA
Presentation Documents
OBJECTIVES: Prevalence estimates of MASH (formerly NASH, non-alcoholic steatohepatitis) range from 115-506 cases per 100,000 adults. MASH is considered common among people ≥65 years of age but the exact prevalence is unknown. This analysis characterized the epidemiology of MASH among US older adults.
METHODS: Medicare 100% fee-for-service claims (MCR; 2016-2021), Optum’s de-identified Clinformatics® Data Mart Database (CDM) and Veradigm’s electronic health record (EHR)- linked to Komodo claims (both 2015-2022). NASH was defined by ≥1 inpatient claim with a primary or secondary diagnosis of K75.81 (NASH) or ≥2 outpatient claims. Within Veradigm, NASH was additionally defined by ≥1 EHR record with a NASH diagnosis. Data collection was restricted to those ≥65 years. Cases with individuals featuring ≥6 months of baseline data before first NASH diagnosis were considered incident. Demographics, incidence, and prevalence per 100,000 were summarized. A range of period prevalence estimates was estimated using: denominators based on those with 6- and 12-months follow-up; prevalence in the midpoint year; and average numbers of older adults across study period. Annual prevalence was scaled to approximate the frequency in the 2022 US population ≥65 years.
RESULTS: There were 51,343 (MCR),14,982 (CDM), and 144,172 (Veradigm) adults ≥65 years of age with NASH identified. Over follow-up, annual incidence was 11.6-26.5 (MCR), 26.9-49.4 (CDM), and 67.0-74.5 (Veradigm) per 100,000. Prevalence increased annually from 2016 to 2020, ranging from 49.2-91.4 in MCR, 49.0-176.6 in CDM, and 92.5-158.6 in Veradigm. Period prevalence was 169.5-199.3 (MCR), 143.3-286.5 (CDM), and 357.8-594.8 (Veradigm). In 2022, the extrapolated US older adult population with NASH was 47,701 (MCR), 81,007 (CDM), and 99,115 (Veradigm).
CONCLUSIONS: Findings demonstrate substantial and increasing prevalence of MASH among older adults. As the definition of NASH used within CDM and MCR was more specific vs. the broader definition within Veradigm, estimates from these databases provide lower and upper bounds.
Conference/Value in Health Info
Value in Health, Volume 27, Issue 6, S1 (June 2024)
Code
EPH50
Topic
Epidemiology & Public Health
Disease
Gastrointestinal Disorders, No Additional Disease & Conditions/Specialized Treatment Areas