Season of Science: Twelve Papers Advancing Diagnostic Imaging
Day 9
Today’s feature focuses on the economic impact of imaging in the era of new MASH therapeutics. With the FDA’s approval of resmetirom, health systems face an urgent question: How do we diagnose and monitor patients accurately and affordably at scale?
This analysis, published in the Journal of Medical Economics, evaluated three diagnostic and monitoring pathways, cT1, VCTE, and liver biopsy, across both Veterans Health Administration (VHA) and Medicare populations. The findings show that cT1 provides the least costly and most clinically appropriate approach for widespread adoption of resmetirom.Key findings:
1. cT1 resulted in the lowest per-patient cost across both health systems.
• VHA: $7,022 per patient with cT1 vs. $7,286 (biopsy) and $28,509 (VCTE).
• Medicare: $11,866 per patient with cT1 vs. $15,488 (biopsy) and $27,539 (VCTE).
(Tables 2 & 4)
2. VCTE produced the highest false-positive rates, leading to large numbers of inappropriate treatment allocations and dramatically inflated costs.
• In VHA modelling, VCTE misallocated over 1 million patients to treatment incorrectly (Fig. 2B).
• cT1 appropriately ruled out 88% of non-eligible patients, comparable to biopsy but safer and far less costly.
3. For monitoring response to therapy, cT1 clearly outperformed VCTE.
• cT1 correctly identified 67% of non-responders, compared with just 21% using VCTE.
• This reduces unnecessary drug spend and protects patients from ineffective treatment.
4. Budget impact modelling remained robust across multiple scenarios.
• Even when resmetirom drug costs doubled, cT1 still had the lowest budget impact.
• Reducing monitoring frequency to once annually further amplified savings with cT1.
(Tables 3 & 5)
5. Biopsy, is invasive and costly for widespread, repeated use, reinforcing the need for noninvasive, scalable tools such as cT1.
Why this matters:
As MASH enters the era of approved therapeutics, precision in diagnosis and monitoring becomes critical, not only for clinical effectiveness but also for sustainable health system economics.
This study positions cT1 as the leading imaging biomarker for supporting resmetirom adoption in large public payer systems, offering both clinical accuracy and major budget savings.
Read the full paper here:
tandfonline.com/doi/10.1080/…
Tomorrow we continue our journey through the year’s most influential imaging research.
#Perspectum #SeasonOfScience #Resmetirom #HealthEconomics #LiverMultiScan #PrecisionMedicine