Patient advocates and friends of the podcast Mike Betel (Fatty Liver Alliance), Tony Villiotti (NASHkNOWledge) and Wayne Eskridge (Fatty Liver Foundation) join co-hosts Louise Campbell and Roger Green to share a range of impressions on a public comments session around the draft report released by the Institute for Clinical and Economic Review (ICER) on resmetirom and obeticholic acid for NASH.
In this conversation, Roger begins with the note that if the cost of biopsy is factored into the cost of diagnosing a patient, the cost of diagnosis will be absurd. The group goes on to more extensively explore the role of biopsy in prescribing NASH therapeutics. Wayne shares the idea that lifestyle adjustments take time and can be tremendously difficult to maintain. He asserts that because of this, it would be incredibly valuable if there were a therapeutic option that at least halted progression and in turn provides the time to successfully see through lifestyle interventions. Roger relates this perspective to how we consider trial endpoints. Louise adds comments around the recurring idea that while not every patient is symptomatic, we know this is a progressive disease which doesn’t necessarily fit the sort of spectrum described by ICER. Towards the end of the episode, Mike notes that the public comments session as a whole was rather liver-centric and siloed from more holistic metabolic thinking.
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