Cost-effectiveness of Traditional Persian Medicine-Based Diet on NonAlcoholic Fatty Liver Disease

Marita Mohammadshahi; Nafiseh Hosseini Yekta; Mahshid Chaichi-Raghimi; Mohammadreza  Mobinizadeh; Zeinab Fakoorfard; Parisa Aboee; Alireza Olyaeemanesh; Zahra  Gharib-Naseri

doi:10.18502/htaa.v8i1.15025

Marita Mohammadshahi Iran’s National Institute for Health Research, Tehran, Iran
Nafiseh Hosseini Yekta Department of Traditional Medicine, School of Traditional Medicine. Shahid Beheshti University of Medical Sciences, Tehran, Iran. Traditional Medicine & Matria Medica Research Center, School of Traditional Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Mahshid Chaichi-Raghimi Persian Medicine Office, Ministry of Health, Treatment, and Medical Education, Tehran, Iran
Mohammadreza Mobinizadeh Iran’s National Institute for Health Research, Tehran, Iran
Zeinab Fakoorfard Iran’s National Institute for Health Research, Tehran, Iran
Parisa Aboee Iran’s National Institute for Health Research, Tehran, Iran
Alireza Olyaeemanesh Iran’s National Institute for Health Research, Tehran, Iran
Zahra Gharib-Naseri Department of Pharmacoeconomics and Pharmaceutical Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/htaa.v8i1.15025

Keywords: Traditional Persian Medicine; Non-Alcoholic Fatty Liver; Cost-Effectiveness

Abstract

Background: In the context of Persian traditional medicine, there are several therapeutic strategies for managing diseases, ranging from lifestyle changes to herbal remedies.

Objectives: Given the application of Persian traditional medicine in the management of chronic diseases, the burden of chronic illnesses, and the public’s recourse to traditional medicine specialists, this study aimed to assess the cost-effectiveness of traditional medicine dietary regimens for the treatment of non-alcoholic fatty liver disease from the perspective of the payer.

Methods: In this study, we investigated the cost-effectiveness of providing nutrition counseling for lifestyle modification (changes in the aforementioned Setteh-e-Zarurieah) by a traditional medicine specialist compared to receiving counseling from a nutritionist for nonalcoholic fatty liver disease from the payer’s perspective. The outcomes measured were changes in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) enzymes, body mass index (BMI), and the grade of fatty liver. Cost and effectiveness data were entered into Excel software, and the ICER ratio was calculated

Results: The results indicated that the dietary regimen prescribed by Persian traditional medicine when compared to the nutritionist’s recommended diet, resulted in a lower decrease in AST and ALT enzymes but led to a greater decrease in BMI (mean change = 0.42) and a significant change in the grade of fatty liver (OR = 9.75). Since the costs of tests, ultrasounds, and visits were equal in both groups, the cost difference was zero. In the first scenario, where traditional medicine is considered an alternative therapy and liver enzymes are the primary focus, providing nutritional counseling services by Persian traditional medicine may not be cost-effective. However, if we consider the grade of fatty liver and BMI as the primary variables, providing nutritional counseling services by Persian traditional medicine may be cost-effective.

Conclusions: Based on the available evidence, the treatment of fatty liver using Persian traditional medicine can be considered an effective and cost-effective complementary (or alternative) intervention. Considering the long-term costs imposed by the health system and insurance organizations, it is predicted that adding visits to Persian traditional medicine specialists may reduce overall healthcare system costs.