Cost and value in liver disease guidelines: 2011-2022

Abstract

Background: Chronic liver disease (CLD) is associated with rising health care utilization and cost. We aimed to describe the frequency of cost/value (C/V) statements in CLD-related clinical guidance documents (CGDs). Methods: CGD with a focus on CLD published between January 2011 and February 2022 from 3 US societies [Association for the Study of Liver Diseases (AASLD), American College of Gastroenterology (ACG), and American Gastroenterological Association (AGA)] were analyzed. Findings: Forty-five CGDs were identified. Eighty of 1334 guidance statements were C/V statements (6%). Only 1.1% reported patient-level costs and none reported out-of-pocket costs. Despite the increased importance of incorporating cost and value into care, the proportion of C/V statements in CGDs related to liver disease is low.