{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:33:34Z","timestamp":1790775214572,"version":"4.1.0"},"reference-count":33,"publisher":"The Korean Association for the Study of the Liver","issue":"1","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002380","name":"Hanyang University","doi-asserted-by":"publisher","award":["HY-202100000003681"],"award-info":[{"award-number":["HY-202100000003681"]}],"id":[{"id":"10.13039\/501100002380","id-type":"DOI","asserted-by":"publisher"}]},{"name":"KIST Institutional Program","award":["2E33111-24-042"],"award-info":[{"award-number":["2E33111-24-042"]}]},{"name":"Patient-Centered Clinical Research Coordinating Center"},{"DOI":"10.13039\/501100003625","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["HC23C0058"],"award-info":[{"award-number":["HC23C0058"]}],"id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Seoul RISE Center","award":["2025-RISE-01-027-01"],"award-info":[{"award-number":["2025-RISE-01-027-01"]}]},{"DOI":"10.13039\/501100002701","name":"Ministry of Education","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002701","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Seoul Metropolitan Government"}],"content-domain":{"domain":["e-cmh.org"],"crossmark-restriction":true},"short-container-title":["CMH"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:p>Background\/Aims: The first metabolic dysfunction-associated steatotic liver disease (MASLD) drug was approved with an unsatisfactorily small effect size. This study aimed to determine key factors impacting the cost-effectiveness of a new hypothetical MASLD drug as well as its treatment efficacy.Methods: A Markov model reflecting the natural history of MASLD was developed, incorporating fibrosis progression, cardiovascular disease risk, and mortality. Treatment effect of drug X (with $20,000 of annual cost) was assumed to achieve a \u22651 stage fibrosis regression, with a 25% gap of effect size in regression rate over non-treatment in the first year. The incremental cost-effectiveness ratio (ICER) over a 20-year horizon was estimated. And sensitivity analyses were conducted to explore uncertainty and identify influential factors.Results: In the base case analysis, drug X provided an incremental gain of 1.32 quality-adjusted life years (QALYs) and 1.20 life years compared to the non-treatment, with an ICER of $68,010\/QALY\u2013below the $100,000\/QALY willingnessto- pay threshold, indicating that drug X treatment is cost-effective. Two-way sensitivity analysis further highlighted that the drug should achieve at least a 15% initial regression gap and maintain a minimum 3% sustained durability gap to remain cost-effective. In addition baseline fibrosis stage distribution also acted as an influencing factor.Conclusions: Long-term sustained durability of the hypothetical drug, patient distribution based on baseline fibrosis stage, as well as initial treatment response rate are key factors that influence the cost-effectiveness of new MASLD drugs.<\/jats:p>","DOI":"10.3350\/cmh.2025.0796","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T08:00:53Z","timestamp":1762156853000},"page":"276-288","update-policy":"https:\/\/doi.org\/10.3350\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Evaluating treatment response thresholds for cost-effective treatment in metabolic dysfunction-associated steatotic liver disease"],"prefix":"10.3350","volume":"32","author":[{"given":"Eileen L.","family":"Yoon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong-Yeon","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiyul","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimi","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Hyeon","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9091-8787","authenticated-orcid":true,"given":"Hye-Lin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2875-6139","authenticated-orcid":true,"given":"Dae Won","family":"Jun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1902","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17158"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0351"},{"key":"ref3","first-page":"528","volume-title":"American Association of Clinical Endocrinology clinical practice guideline for the diagnosis and management of nonalcoholic fatty liver disease in primary care and endocrinology clinical settings: co-sponsored by the American Association for the Study of Liver Diseases (AASLD)","author":"Cusi","year":"2022"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-024-06196-3"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.04.005"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2019.10.001"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.04.043"},{"key":"ref8","first-page":"497","volume-title":"A phase 3, randomized, controlled trial of resmetirom in NASH with liver fibrosis","author":"Harrison","year":"2024"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.2310"},{"key":"ref10","first-page":"944","volume-title":"Cost-effectiveness study of FIB-4 followed by transient elastography screening strategy for advanced hepatic fibrosis in a NAFLD at-risk population","author":"Park","year":"2024"},{"key":"ref11","volume-title":""},{"key":"ref12","volume-title":""},{"key":"ref13","volume-title":""},{"key":"ref14","volume-title":""},{"key":"ref15","volume-title":""},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29085"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.05.036"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29466"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.5124\/jkma.2011.54.11.1199"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.07.050"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.05.002"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14292"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s41669-022-00370-2"},{"key":"ref24","volume-title":"","author":"Tice"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1056\/nejmp1405158"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1111\/apt.16763"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2022.2026702"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2024.04.016"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2502242"},{"key":"ref30","first-page":"102530","volume-title":"Assessing the efficacy of farnesoid X receptor agonists in the management of metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis: efficacy of Farnesoid X receptor agonists in metabolic dysfunction-associated steatotic liver disease: systematic review and meta-analysis","author":"Kumar","year":"2025"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2401755"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.587"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-1113"}],"container-title":["Clinical and Molecular Hepatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-cmh.org\/upload\/pdf\/cmh-2025-0796.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-cmh.org\/journal\/view.php?doi=10.3350\/cmh.2025.0796","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-cmh.org\/upload\/pdf\/cmh-2025-0796.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T08:00:22Z","timestamp":1768377622000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-cmh.org\/journal\/view.php?doi=10.3350\/cmh.2025.0796"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"URL":"https:\/\/doi.org\/10.3350\/cmh.2025.0796","relation":{},"ISSN":["2287-2728","2287-285X"],"issn-type":[{"value":"2287-2728","type":"print"},{"value":"2287-285X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,1]]},"assertion":[{"value":"2025-07-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-30","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-03","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}