Cost-effectiveness analysis of MASLD screening using FIB-4 based two-step algorithm in the medical check-up
Abstract Screening for metabolic dysfunction-associated steatotic liver disease (MASLD) across the entire general population is not currently a recommended strategy. However, it is not uncommon to receive a medical check-up or health check-up for a various of reasons. We tried to investigate whether...
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Nature Portfolio
2025-06-01
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| Online Access: | https://doi.org/10.1038/s41598-025-01740-6 |
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| author | Mimi Kim Huiyul Park Eileen L. Yoon Ramsey Cheung Donghee Kim Hye-Lin Kim Dae Won Jun |
| author_facet | Mimi Kim Huiyul Park Eileen L. Yoon Ramsey Cheung Donghee Kim Hye-Lin Kim Dae Won Jun |
| author_sort | Mimi Kim |
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| description | Abstract Screening for metabolic dysfunction-associated steatotic liver disease (MASLD) across the entire general population is not currently a recommended strategy. However, it is not uncommon to receive a medical check-up or health check-up for a various of reasons. We tried to investigate whether advanced fibrosis screening in MASLD patients is cost-effective for adults aged 40–49 years during medical or health check-up. The target group for analysis was adults who received medical check-ups for various reasons in the United States. We constructed a hybrid model of the decision tree model and Markov model to compare expected costs and quality-adjusted life-years (QALYs) between ‘screening’ and ‘no screening’ groups from healthcare system perspectives. Patients diagnosed MASLD with advanced fibrosis by FIB4 and VCTE were given intensive lifestyle intervention (ILI). The incremental cost-effectiveness ratio (ICER) was calculated for a 30-year horizon. Assuming effect of ILI is limited to regression of liver fibrosis, ICER of the FIB-4-based two steps algorithm was $103,405 per QALY in adults aged 40–49 years, which was slightly above the threshold value ($100,000/QALY). And in those in adults aged 50–59 and 60–69 years, the ICER was $137,593 and $197,901 per QALY, respectively. If we assume the effect of ILI can improve liver fibrosis as well as cardiovascular disease events, ICERs of screening in aged 40–49 and 50–59 years were $74,596, and $95,974 per QALY, respectively. In an analysis that included additional positive effect on extrahepatic cancer by ILI, estimated ICERs were below the threshold in those in aged 40–49 and 50–59 years. Advanced fibrosis screening in MASLD patients using the FIB-4-based two-step algorithm and ILI was cost-effective for adults aged 40–49 years, taking into account both liver fibrosis and cardiovascular disease. |
| format | Article |
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| issn | 2045-2322 |
| language | English |
| publishDate | 2025-06-01 |
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| spelling | doaj-art-ec7fb440b5b64a34b2b22bfece50e0952025-08-20T02:30:46ZengNature PortfolioScientific Reports2045-23222025-06-011511910.1038/s41598-025-01740-6Cost-effectiveness analysis of MASLD screening using FIB-4 based two-step algorithm in the medical check-upMimi Kim0Huiyul Park1Eileen L. Yoon2Ramsey Cheung3Donghee Kim4Hye-Lin Kim5Dae Won Jun6Department of Radiology, Hanyang University College of MedicineDepartment of Family Medicine, Myoungji Hospital, Hanyang University College of MedicineDepartment of Internal Medicine, Hanyang University College of MedicineDivision of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical CenterDivision of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical CenterDivision of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical CenterDepartment of Internal Medicine, Hanyang University College of MedicineAbstract Screening for metabolic dysfunction-associated steatotic liver disease (MASLD) across the entire general population is not currently a recommended strategy. However, it is not uncommon to receive a medical check-up or health check-up for a various of reasons. We tried to investigate whether advanced fibrosis screening in MASLD patients is cost-effective for adults aged 40–49 years during medical or health check-up. The target group for analysis was adults who received medical check-ups for various reasons in the United States. We constructed a hybrid model of the decision tree model and Markov model to compare expected costs and quality-adjusted life-years (QALYs) between ‘screening’ and ‘no screening’ groups from healthcare system perspectives. Patients diagnosed MASLD with advanced fibrosis by FIB4 and VCTE were given intensive lifestyle intervention (ILI). The incremental cost-effectiveness ratio (ICER) was calculated for a 30-year horizon. Assuming effect of ILI is limited to regression of liver fibrosis, ICER of the FIB-4-based two steps algorithm was $103,405 per QALY in adults aged 40–49 years, which was slightly above the threshold value ($100,000/QALY). And in those in adults aged 50–59 and 60–69 years, the ICER was $137,593 and $197,901 per QALY, respectively. If we assume the effect of ILI can improve liver fibrosis as well as cardiovascular disease events, ICERs of screening in aged 40–49 and 50–59 years were $74,596, and $95,974 per QALY, respectively. In an analysis that included additional positive effect on extrahepatic cancer by ILI, estimated ICERs were below the threshold in those in aged 40–49 and 50–59 years. Advanced fibrosis screening in MASLD patients using the FIB-4-based two-step algorithm and ILI was cost-effective for adults aged 40–49 years, taking into account both liver fibrosis and cardiovascular disease.https://doi.org/10.1038/s41598-025-01740-6MASLDCost-effectivenessFIB-4Intensive life style modification |
| spellingShingle | Mimi Kim Huiyul Park Eileen L. Yoon Ramsey Cheung Donghee Kim Hye-Lin Kim Dae Won Jun Cost-effectiveness analysis of MASLD screening using FIB-4 based two-step algorithm in the medical check-up Scientific Reports MASLD Cost-effectiveness FIB-4 Intensive life style modification |
| title | Cost-effectiveness analysis of MASLD screening using FIB-4 based two-step algorithm in the medical check-up |
| title_full | Cost-effectiveness analysis of MASLD screening using FIB-4 based two-step algorithm in the medical check-up |
| title_fullStr | Cost-effectiveness analysis of MASLD screening using FIB-4 based two-step algorithm in the medical check-up |
| title_full_unstemmed | Cost-effectiveness analysis of MASLD screening using FIB-4 based two-step algorithm in the medical check-up |
| title_short | Cost-effectiveness analysis of MASLD screening using FIB-4 based two-step algorithm in the medical check-up |
| title_sort | cost effectiveness analysis of masld screening using fib 4 based two step algorithm in the medical check up |
| topic | MASLD Cost-effectiveness FIB-4 Intensive life style modification |
| url | https://doi.org/10.1038/s41598-025-01740-6 |
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