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After a month of major Fatty Liver medical meetings, Jörn Schattenberg, Louise Campbell and Roger Green explore emerging stories that will shape the next 6-12 months in Fatty Liver disease. This conversation speculates where potential bottlenecks in getting drugs to patients might emerge.

Louise points to payers as a significant barrier en route to product adoption. Roger suggests it depends on the healthcare system, but generally agrees with Louise. He references the past development of a Hep C treatment for a comparable example. Payers slowed adoption of drugs with clear long-term benefits due to the short-term cash outlays. Jörn also shares his belief that payers will be the source of bottleneck. He suggests that appropriate patient pathways and stratification provide the best counter-strategy. In response, Louise returns to her point that our health systems are not ready to implement Fatty Liver drug therapy yet, much less over the next 6-12 months.

The conversation then shifts to the more recent theme of a “combo-combo world,” coined by Mazen Noureddin in Season 3, Episode 43. Mazen had introduced the idea that combinations of biomarkers are necessary to diagnose and stage, while combinations of drugs provide optimal therapy. To finish, Jörn discusses the value of the consortia – LITMUS, NIMBLE, NAIL-NIT and Rohit Loomba’s Goldmine – in moving this issue forward.