This conversation starts with Roger discussing the recent Episode 49, in which Kenneth Cusi presented the multi-specialty clinical care pathway approach fostered by the American Gastroenterological Association in harmony with other specialties and Scott Friedman’s comments in Episode 55 about NASH as an environmental disease caused by changes in global diets and their effect on the liver through microbiome.
Jeff notes that he sees working in parallel with environmental and active lifestyle advocates as a cause for hope. The conversation shifts to the growth rates for cirrhosis in countries around the world and what that implies in terms of how fast the patient load will double or triple. This will cause increases in cost and worker demand nations are not prepared to address. The final question asks the group where panelists believe they can have the greatest impact, which leads to a follow-up question from Roger about whether stating aggressive incidence numbers might scare off payers, particularly private payers in the US. Jeff agrees this might be a risk as the session ends.