Liver disease is a common cause of premature death in the UK. Recently, The Lancet Commission on Liver Disease highlighted the financial impact liver disease places on the national healthcare system and businesses, and suggested strategies to reduce these burdens.
The negative impacts of liver disease on citizens under the age of 65 in the UK are escalating, particularly in those from low socioeconomic backgrounds. This can be reversed by targeting the three main causes of liver disease: alcohol misuse, obesity, and viral hepatitis. Previous attempts to change health outcomes through voluntary agreements with the food and drinks industries failed, emphasizing the need for tougher measures. Such measures are discussed in The Lancet Commission on Liver Disease for each of the three risk factors.
Alcohol abuse causes various medical problems: in the UK alone 60% of all liver disease and 84% liver-related deaths are caused by alcohol misuse. Alcohol abuse places huge financial burdens on hospitals (£3.5 billion in 2009/10) and crime prevention (£13 billion/year). Work productivity also declines due to poor health (£7.3 billion/year) and more child services are required due to neglect and mistreatment. It is estimated that alcohol-related issues will cost the healthcare system £17 billion over the next five years. Key points for resolving these issues surround the availability, affordability, and acceptability of alcohol. These can be achieved by restricting trading hours, making alcohol less affordable, and applying stronger regulations to alcohol marketing and advertising.
Obesity levels are also increasing rapidly. In 2015, 63% adults in the UK were obese or overweight, and this corresponds with an increasing number of adults and children presenting with non-alcoholic fatty liver disease. As with alcohol abuse, obesity places huge financial strains on hospitals, social care, workplaces, and welfare support agencies. If this situation continues, it is estimated that obesity-related issues will add £1.9-2 billion per year to health costs and cost businesses £14 billion by 2035. Recommended interventions include banning TV junk food advertisements before 9 pm (to decrease children’s exposure to unhealthy food marketing), introducing food taxes in addition to the Soft Drinks Levy, and regulating price promotions on unhealthy foods and drinks. Offering weight-loss surgery to obese people with diabetes is also recommended.
Viral hepatitis (Hepatitis B and C) can lead to severe liver disease. The incidence of viral hepatitis in the UK is increasing. It is thought that between 216 000 and 446 000 individuals may be infected with Hepatitis C, and the same again with Hepatitis B. Unfortunately, the UK is lagging behind other countries in terms of detection and treatment. Efforts to improve access to testing, early diagnosis and appropriate treatment must be made. It is estimated that £3.2 billion could be saved over the next 30 years simply by providing treatment to those infected with Hepatitis C.
Given the failure of voluntary agreements in preventing the spiralling financial impact of liver disease, the authors ask that the government impose mandatory regulations based on the recommendations presented in this report. These measures would not only reduce the prevalence of liver disease, but would also have positive effects on other areas of health and wellbeing, and further reduce the financial burden on society.
Written by Natasha Tetlow, PhD
The Foundation for Liver Research. Financial case for action on liver disease: Escalating costs of alcohol misuse, obesity and viral hepatitis. Lancet Commission on Liver Disease. 2017. Available at: http://www.liver-research.org.uk/liverresearch-assets/financialcaseforactiononliverdiseasepaper.pdf