Hepatic Encephalopathy Epidemiology

Key Highlights

• Hepatic Encephalopathy diagnosed prevalence is expected to rise, driven by increased awareness, increased health care concerns, longer life expectancy as well as changes in cirrhosis admission.
• In 2023, the US accounted for the maximum diagnosed patient share of Hepatic Encephalopathy in the 7MM, i.e., 61%, followed by Japan accounting for around 9% of the total 7MM cases. Among the European countries higher number of cases were in the UK accounting for about 8% of the total 7MM cases. 
• According to the analysis conducted by DelveInsight, Hepatic Encephalopathy was diagnosed in approximately 35% of females and 65% of males within EU4 and the UK in 2023. This analysis indicates a higher prevalence of Hepatic Encephalopathy among males than females.
• The highest proportion of Hepatic Encephalopathy cases was estimated in the 45-54 years age group in Japan, while age group of <25 years had least cases.

DelveInsight’s “Hepatic Encephalopathy – Epidemiology – 2034” report delivers an in-depth understanding of the Hepatic Encephalopathy, historical and forecasted epidemiology in the United States, EU4 (Germany, France, Italy, and Spain) and the United Kingdom, and Japan.

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Geography Covered

• The United States
• EU4 (Germany, France, Italy, and Spain) and the United Kingdom
• Japan

Study Period: 2021-2034

Disease Understanding and Diagnostic Algorithm

Hepatic Encephalopathy Overview

Hepatic encephalopathy is a brain disorder that develops in some individuals with liver disease. It is a complex disorder encompassing a spectrum or continuum of disease that ranges from a subtle condition with no outward signs or symptoms to a severe form that can cause serious, life-threatening complications. hepatic encephalopathy is classified into two broad categories based on severity, covert hepatic encephalopathy (CHE) and overt hepatic encephalopathy (OHE). Presently, defining and diagnosing hepatic encephalopathy is quite challenging. In CHE, there are no clear clinical signs or symptoms as presented in OHE.

It is presumed that hepatic encephalopathy is a predictor of death. The hepatic functions and prognosis get worse after the diagnosis of the disease. The patients are often referred to a liver transplant center at a later stage, which is not a very economical option. Also, this disease levies a significant burden on patients, such as psychological and social functioning, other than morbidity and mortality. Expenditures related to patients’ caregivers, hospitalization, and society get increased. Moreover, hepatic encephalopathy can impact the patient’s ability to work, resulting in reduced productivity and lost wages. Thus, the overall quality of life of patients gets hampered. Given the social and financial burden of HE, cost-effective management of hepatic encephalopathy is crucial. Early prevention is important to minimize the societal and economic costs associated with hepatic encephalopathy.

Hepatic Encephalopathy Diagnosis

Hepatic encephalopathy is a common complication of liver dysfunction, including acute liver failure and liver cirrhosis. hepatic encephalopathy presents as a spectrum of neuropsychiatric symptoms ranging from subtle fluctuating cognitive impairment to coma. There is no specific diagnostic test for HE, and diagnosis is based on clinical suspicion, excluding other causes and the use of clinical tests that may support its diagnosis. Many tests are used in trials but have not yet gained universal acceptance. Currently, diagnosis is based on eliminating other causes, establishing liver disease, and psychometric testing. Ammonia (regardless of level) does not add any diagnostic, staging, or prognostic value for hepatic encephalopathy. Also, there is a long list of disorders that could mimic or associate with hepatic encephalopathy and are considered for purposes of differential diagnosis. Thus, there is an unmet need to develop diagnostic tests (laboratory or imaging) which help early diagnosis and treatment monitoring.

None of the manifestations of type CHE are specific, and there are no clinical markers, which are truly useful in distinguishing between OHE and other neurological alterations of metabolic origin that may occur in patients with cirrhosis but are not causally related to liver disease. Ammonia levels within the normal range have a high negative predictive value and virtually no false negatives on measurement. Thus, a prerequisite of diagnostic guidelines and specific procedures for diagnosing hepatic encephalopathy and its subtypes are current unmet needs.

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Hepatic Encephalopathy Epidemiology

As the market is derived using the patient-based model, the Hepatic Encephalopathy epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by Diagnosed Prevalent Cases of Hepatic Encephalopathy, Gender-specific Diagnosed Prevalent Cases of Hepatic Encephalopathy, Age-specific Diagnosed Prevalent Cases of Hepatic Encephalopathy, and Type-specific Diagnosed Prevalent Cases of Hepatic Encephalopathy in the 7MM covering the United States, EU4 countries (Germany, France, Italy, and Spain) and the United Kingdom, and Japan, from 2021 to 2034. As per DelveInsight’s estimations, the total diagnosed prevalent cases of Hepatic Encephalopathy in the 7MM were approximately 342 thousand cases in 2023 and are projected to increase during the forecast period (2024–2034).

• The total diagnosed prevalent cases of hepatic encephalopathy in the US are expected to increase with a significant CAGR by 2034, from around 209 thousand cases in 2023 in the US.
• Among the European countries, the UK (28%) had the highest diagnosed prevalent population of hepatic encephalopathy, followed by Germany in 2023. On the other hand, Spain had the least diagnosed prevalent population around 9% of Hepatic Encephalopathy in the same year.
• In Japan, among diagnosed prevalence cases of Hepatic Encephalopathy, most cases were of Covert Hepatic Encephalopathy (~17.7 thousand) in 2023. While Overt Hepatic Encephalopathy cases were around 11.8 thousand in the same year.
• The Hepatic Encephalopathy diagnosed cases were segmented based on age in seven age‐groups <25 years, 25-34 years, 35-44 years, 45-54 years, 55-64 years, 65-74 years, and 75+ years, Our estimate suggests that in the US highest number of cases were in the age goup 45-54 years (41%)  and the least in <25 years (3%) in 2023.
• Assessments as per DelveInsight’s analysts show that the majority of cases of Hepatic Encephalopathy are occupied by males as compared to females. There were approximately 152 thousand male and 57 thousand female cases of Hepatic Encephalopathy in 2023 in the US.

KOL Views

To gaze into the epidemiology insights of the real world, we take KOLs and SMEs’ opinions working in the domain through primary research to fill the data gaps and validate the secondary research. Industry Experts were contacted for insights on Hepatic Encephalopathy evolving treatment landscape, patient reliance on conventional therapies, patient therapy switching acceptability, along with challenges related to accessibility, including KOL from University of California, Los Angeles, US; UCL Institute for Liver and Digestive Health, UK; P University of Padova, Italy; University of Washington, US, and others.

Delveinsight’s analysts connected with 50+ KOLs to gather insights; however, interviews were conducted with 15+ KOLs in the 7MM. Their opinion helps understand and validate current disease prevalence, gender involved with the disease, diagnosis rate, and diagnostic criteria.

Scope of the Report

• The report covers a segment of key events, an executive summary, descriptive overview of Hepatic Encephalopathy, explaining its causes, signs and symptoms, and pathogenesis.
• Comprehensive insight has been provided into the epidemiology segments and forecasts, the future growth potential of diagnosis rate, disease progression, and treatment guidelines.
• The report provides an edge for understanding trends, expert insights/KOL views, and patient journeys in the 7MM.
• A detailed review of current challenges in establishing the diagnosis.

Hepatic Encephalopathy Report Insights

• Patient Population
• Country-wise Epidemiology Distribution
• Diagnosed Prevalence of Hepatic Encephalopathy
• Gender-specific Diagnosed Prevalent Cases of Hepatic Encephalopathy
• Age-specific Diagnosed Prevalent Cases of Hepatic Encephalopathy
• Type-specific Diagnosed Prevalent Cases of Hepatic Encephalopathy 

Hepatic Encephalopathy Report Key Strengths

• 11 years Forecast
• The 7MM Coverage 
• Hepatic Encephalopathy Epidemiology Segmentation

Key Questions

Epidemiology Insights

• What are the disease risks, burdens, and unmet needs of Hepatic Encephalopathy? What will be the growth opportunities across the 7MM concerning the patient population of Hepatic Encephalopathy?
• What is the historical and forecasted Hepatic Encephalopathy patient pool in the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan?
• Why do only limited patients appear for diagnosis? 
• Which country is more prevalent for Hepatic Encephalopathy and why?
• What factors are affecting the diagnosis of the indication? 

Reasons to Buy

• Insights on patient burden/disease, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
• To understand the Hepatic Encephalopathy prevalence cases in varying geographies over the coming years.
• A detailed overview of Type, Gender, and Age-specific diagnosed prevalence of Hepatic Encephalopathy.
• To understand the perspective of key opinion leaders around the current challenges with establishing the diagnosis options.
• Detailed insights on various factors hampering disease diagnosis and other existing diagnostic challenges.

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Frequently Asked Questions

1. What is the forecast period covered in the report?

The Hepatic Encephalopathy Epidemiology report for the 7MM covers the forecast period from 2024 to 2034, providing a projection of epidemiology dynamics and trends during this timeframe.

2. Out of all EU4 countries and the UK, which country had the highest population of Hepatic Encephalopathy cases in 2023?

The highest cases of Hepatic Encephalopathy was found in the UK, among EU4 and the UK, in 2023.

3. How is epidemiological data collected and analyzed for forecasting purposes?

Epidemiological data is collected through surveys, clinical studies, health records, and other sources. It is then analyzed to calculate disease rates, identify trends, and project future disease burdens using mathematical models.

4. Out of all 7MM countries, which country had the highest population of Hepatic Encephalopathy cases in 2023?

The highest cases of Hepatic Encephalopathy were found in the US, among the 7MM, in 2023.