'It Pays' to Check the Gut Microbiome in Patients With Cirrhosis
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Gut microbiota analysis was cost-effective for predicting and possibly preventing 90-day readmissions for cirrhosis, according to study results.
Jasmohan S. Bajaj, MD, professor of medicine at Virginia Commonwealth University, told Healio Gastroenterology and Liver Disease that changes to the microbiota lend to complications of cirrhosis leading to high hospitalization rates. Previous studies have shown that these changes in the gut microbiota can independently add to the prediction of complications.
“As clinicians we often struggle to translate biomedical research findings into clinical practice and one barrier raised is related to costs,” Bajaj said. “Therefore, we performed a cost-effectiveness analysis and showed that even the most expensive, in-depth microbial analysis can predict and potentially prevent 90-day hospitalizations in patients with cirrhosis.”
Researchers used a Markov model of 1,000 patients with cirrhosis over 90 days to model microbiota testing using 16srRNA ($250 per sample), low-depth ($350 per sample) and high-depth ($650 per sample) metagenomics added to standard of care for prevention of admissions using standard outcome costs and rates of development. They created quality of life years and incremental cost-effectiveness ratios for base scenarios and conducted sensitivity analyses by changing cost for outcomes, like transplantation, death and admission, and admission rates (40%, range 25%–60%).
Bajaj and colleagues found that if admissions were reduced by 5% over standard of care, microbiota analysis was cost-saving ($47,000–$97,000) at $250 and $350 per sample. If admissions were cut by more than 10%, the $650-per sample analysis was cost saving.
Bajaj said this included robust sensitivity analyses of microbial costs and ability to predict across populations and strategies.
“It assumed that a relatively low-cost therapy could beneficially alter the microbiota composition to prevent these outcomes once these changes are discovered, which could be advising them regarding a Mediterranean diet,” he said. “In short, it pays to check the gut microbes in patients with cirrhosis." – by Alex Young
Disclosure: The authors report no relevant financial disclosures.
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