Costs of a structured early detection program for advanced liver fibrosis and cirrhosis: insights on the "plus" of Check-up 35+
- Publikationstyp:
- Zeitschriftenaufsatz
- Metadaten:
-
- Autoren
- Julia Ortner
- Reyn Joris Van Ewijk
- Louis Velthuis
- Christian Labenz
- Anita Arslanow
- Marcus-Alexander Woerns
- Matthias Christian Reichert
- Erik Farin-Glattacker
- Urs Alexander Fichtner
- Dominikus Stelzer
- Peter Robert Galle
- Frank Lammert
- Autoren-URL
- https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=fis-test-1&SrcAuth=WosAPI&KeyUT=WOS:000911316500001&DestLinkType=FullRecord&DestApp=WOS_CPL
- DOI
- 10.1055/a-1989-1971
- eISSN
- 1439-7803
- Externe Identifier
- Clarivate Analytics Document Solution ID: U3LX1
- PubMed Identifier: 36623821
- ISSN
- 0044-2771
- Ausgabe der Veröffentlichung
- 10
- Zeitschrift
- ZEITSCHRIFT FUR GASTROENTEROLOGIE
- Schlüsselwörter
- chronic liver disease
- cirrhosis
- cost analysis
- health economics
- hepatic fibrosis
- non-invasive tests
- screening
- Paginierung
- 1371 - 1381
- Datum der Veröffentlichung
- 2023
- Status
- Published
- Titel
- Costs of a structured early detection program for advanced liver fibrosis and cirrhosis: insights on the "plus" of Check-up 35+
- Sub types
- Article
- Ausgabe der Zeitschrift
- 61
Datenquelle: Web of Science (Lite)
- Andere Metadatenquellen:
-
- Abstract
- <jats:title>Abstract</jats:title><jats:p> Background The implementation of an early detection program for liver cirrhosis in a general population has been discussed for some time. Recently, the effectiveness of a structured screening procedure, called SEAL (Structured Early detection of Asymptomatic Liver cirrhosis), using liver function tests (AST and ALT) and APRI to early detect advanced fibrosis and cirrhosis in participants of the German “Check-up 35” was investigated.</jats:p><jats:p> Methods This study identifies the expected diagnostic costs of SEAL in routine care and their drivers and reports on prevailing CLD etiologies in this check-up population. The analysis is based on theoretical unit costs, as well as on the empirical billing and diagnostic data of SEAL participants.</jats:p><jats:p> Results Screening costs are mainly driven by liver biopsies, which are performed in a final step in some patients. Depending on the assumed biopsy rates and the diagnostic procedure, the average diagnostic costs are between EUR 5.99 and 13.74 per Check-up 35 participant and between EUR 1,577.06 and 3,620.52 per patient diagnosed with fibrosis/cirrhosis (F3/F4). The prevailing underlying etiology in 60% of cases is non-alcoholic fatty liver disease.</jats:p><jats:p> Discussion A liver screening following the SEAL algorithm could be performed at moderate costs. Screening costs in routine care depend on actual biopsy rates and procedures, attendance rates at liver specialists, and the prevalence of fibrosis in the Check-up 35 population. The test for viral hepatitis newly introduced to Check-up 35 as once-in-a-lifetime part of Check-up 35 is no alternative to SEAL.</jats:p>
- Autoren
- Julia Ortner
- Reyn Joris Van Ewijk
- Louis Velthuis
- Christian Labenz
- Anita Arslanow
- Marcus-Alexander Wörns
- Matthias Christian Reichert
- Erik Farin-Glattacker
- Urs Alexander Fichtner
- Dominikus Stelzer
- Peter Robert Galle
- Frank Lammert
- DOI
- 10.1055/a-1989-1971
- eISSN
- 1439-7803
- ISSN
- 0044-2771
- Ausgabe der Veröffentlichung
- 10
- Zeitschrift
- Zeitschrift für Gastroenterologie
- Sprache
- de
- Online publication date
- 2023
- Paginierung
- 1371 - 1381
- Datum der Veröffentlichung
- 2023
- Status
- Published
- Herausgeber
- Georg Thieme Verlag KG
- Herausgeber URL
- http://dx.doi.org/10.1055/a-1989-1971
- Datum der Datenerfassung
- 2023
- Titel
- Costs of a structured early detection program for advanced liver fibrosis and cirrhosis: insights on the “plus” of Check-up 35+
- Ausgabe der Zeitschrift
- 61
Datenquelle: Crossref
- Abstract
- <h4>Background</h4>The implementation of an early detection program for liver cirrhosis in a general population has been discussed for some time. Recently, the effectiveness of a structured screening procedure, called SEAL (Structured Early detection of Asymptomatic Liver cirrhosis), using liver function tests (AST and ALT) and APRI to early detect advanced fibrosis and cirrhosis in participants of the German "Check-up 35" was investigated.<h4>Methods</h4>This study identifies the expected diagnostic costs of SEAL in routine care and their drivers and reports on prevailing CLD etiologies in this check-up population. The analysis is based on theoretical unit costs, as well as on the empirical billing and diagnostic data of SEAL participants.<h4>Results</h4>Screening costs are mainly driven by liver biopsies, which are performed in a final step in some patients. Depending on the assumed biopsy rates and the diagnostic procedure, the average diagnostic costs are between EUR 5.99 and 13.74 per Check-up 35 participant and between EUR 1,577.06 and 3,620.52 per patient diagnosed with fibrosis/cirrhosis (F3/F4). The prevailing underlying etiology in 60% of cases is non-alcoholic fatty liver disease.<h4>Discussion</h4>A liver screening following the SEAL algorithm could be performed at moderate costs. Screening costs in routine care depend on actual biopsy rates and procedures, attendance rates at liver specialists, and the prevalence of fibrosis in the Check-up 35 population. The test for viral hepatitis newly introduced to Check-up 35 as once-in-a-lifetime part of Check-up 35 is no alternative to SEAL.
- Addresses
- Department of Law and Economics, Johannes Gutenberg Universitat Mainz, Mainz, Germany.
- Autoren
- Julia Ortner
- Reyn Joris Van Ewijk
- Louis Velthuis
- Christian Labenz
- Anita Arslanow
- Marcus-Alexander Wörns
- Matthias Christian Reichert
- Erik Farin-Glattacker
- Urs Alexander Fichtner
- Dominikus Stelzer
- Peter Robert Galle
- Frank Lammert
- DOI
- 10.1055/a-1989-1971
- eISSN
- 1439-7803
- Externe Identifier
- PubMed Identifier: 36623821
- Funding acknowledgements
- Gemeinsamer Bundesausschuss: 01NVF16026
- Open access
- false
- ISSN
- 0044-2771
- Ausgabe der Veröffentlichung
- 10
- Zeitschrift
- Zeitschrift fur Gastroenterologie
- Schlüsselwörter
- Liver
- Humans
- Liver Cirrhosis
- Fibrosis
- Biopsy
- Elasticity Imaging Techniques
- Non-alcoholic Fatty Liver Disease
- Biomarkers
- Sprache
- eng
- Medium
- Print-Electronic
- Online publication date
- 2023
- Paginierung
- 1371 - 1381
- Datum der Veröffentlichung
- 2023
- Status
- Published
- Datum der Datenerfassung
- 2023
- Titel
- Costs of a structured early detection program for advanced liver fibrosis and cirrhosis: insights on the "plus" of Check-up 35.
- Sub types
- Journal Article
- Ausgabe der Zeitschrift
- 61
Datenquelle: Europe PubMed Central
- Abstract
- BACKGROUND: The implementation of an early detection program for liver cirrhosis in a general population has been discussed for some time. Recently, the effectiveness of a structured screening procedure, called SEAL (Structured Early detection of Asymptomatic Liver cirrhosis), using liver function tests (AST and ALT) and APRI to early detect advanced fibrosis and cirrhosis in participants of the German "Check-up 35" was investigated. METHODS: This study identifies the expected diagnostic costs of SEAL in routine care and their drivers and reports on prevailing CLD etiologies in this check-up population. The analysis is based on theoretical unit costs, as well as on the empirical billing and diagnostic data of SEAL participants. RESULTS: Screening costs are mainly driven by liver biopsies, which are performed in a final step in some patients. Depending on the assumed biopsy rates and the diagnostic procedure, the average diagnostic costs are between EUR 5.99 and 13.74 per Check-up 35 participant and between EUR 1,577.06 and 3,620.52 per patient diagnosed with fibrosis/cirrhosis (F3/F4). The prevailing underlying etiology in 60% of cases is non-alcoholic fatty liver disease. DISCUSSION: A liver screening following the SEAL algorithm could be performed at moderate costs. Screening costs in routine care depend on actual biopsy rates and procedures, attendance rates at liver specialists, and the prevalence of fibrosis in the Check-up 35 population. The test for viral hepatitis newly introduced to Check-up 35 as once-in-a-lifetime part of Check-up 35 is no alternative to SEAL.
- Autoren
- Julia Ortner
- Reyn Joris Van Ewijk
- Louis Velthuis
- Christian Labenz
- Anita Arslanow
- Marcus-Alexander Wörns
- Matthias Christian Reichert
- Erik Farin-Glattacker
- Urs Alexander Fichtner
- Dominikus Stelzer
- Peter Robert Galle
- Frank Lammert
- Autoren-URL
- https://www.ncbi.nlm.nih.gov/pubmed/36623821
- DOI
- 10.1055/a-1989-1971
- eISSN
- 1439-7803
- Funding acknowledgements
- Gemeinsamer Bundesausschuss: 01NVF16026
- Ausgabe der Veröffentlichung
- 10
- Zeitschrift
- Z Gastroenterol
- Schlüsselwörter
- Humans
- Liver Cirrhosis
- Liver
- Non-alcoholic Fatty Liver Disease
- Elasticity Imaging Techniques
- Biopsy
- Biomarkers
- Fibrosis
- Sprache
- eng
- Country
- Germany
- Paginierung
- 1371 - 1381
- Datum der Veröffentlichung
- 2023
- Status
- Published
- Datum, an dem der Datensatz öffentlich gemacht wurde
- 2023
- Titel
- Costs of a structured early detection program for advanced liver fibrosis and cirrhosis: insights on the "plus" of Check-up 35.
- Sub types
- Journal Article
- Ausgabe der Zeitschrift
- 61
Datenquelle: PubMed
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