The real cost of liver disease

Dr Jeremy Thompson, RCGP/British Liver Trust Clinical Lead for Liver Disease

The Foundation for Liver Research has recently published the paper 'Financial Case for Action on Liver Disease' which documents the increasing burden of liver disease and liver-related mortality. Liver disease has become one of the most important causes of premature death; results in an estimated 62,000 lost working years each year; and has a disproportionally high impact on the poor, contributing to widening health inequality.

The Foundation argues that recent increases in liver disease prevalence can be reversed through coordinated preventive action and that voluntary agreements with the alcohol and food industries are proving ineffective. The document summarises the escalating costs to the care system and society and makes a financial case for public health action to tackle the main causes of liver disease: alcohol misuse, obesity and chronic viral hepatitis.

Alcohol misuse

Around 20% of men and 15% of women drink at hazardous or harmful levels in the UK. It has been estimated that alcohol misuse has societal costs of at least £21bn per year in England and Wales, and costs are increasing rapidly.

  • Alcohol-related hospital admissions increased by approximately 17% between 2010/11 and 2015/16
  • Working years lost due to alcohol rose from 46,000 in 2010 to 167,000 in 2015, 16% of all working years lost in England
  • The number of claimants of Employment Support Allowance and Incapacity Benefit / Severe Disablement Allowance with alcohol misuse as the primary medical condition grew from 38,910 in May 2011 to 57,940 in May 2015 

Obesity

The UK has an obesity epidemic. Data from 2015 show that 63% of adults aged over 16 are obese or overweight, and one in three children in England is obese or overweight by the time they leave primary school. The total estimated annual cost to society from obesity has grown from £15.8bn in 2007 to £27bn in 2016.

  • Hospital admission episodes where obesity was a primary or secondary diagnosis increased 150% from 211,783 in 2010/11 to 525,000 in 2015/16
  • NHS spending on obesity-related conditions has risen 65% over 10 years to £1bn each year 

Chronic viral hepatitis 

Chronic infection with hepatitis B or C virus is a major health risk to individuals and a wider public health risk. The number of people with chronic hepatitis C infection in the UK is estimated to be 216,000, and the majority are unaware they are infected. Hepatitis B is a major health challenge for the UK, with a similarly large pool of people affected by the disease. Marginalised populations are at greater risk of both infections, notably people who inject drugs, prisoners and immigrant populations.

Data are more limited on the total financial cost of viral hepatitis to society, but for hepatitis C alone, it is thought that lost productivity is worth up to £367m per year.

  • Between 2010 and 2015 estimated cases of hepatitis C-related cirrhosis or hepatocellular carcinoma increased from 1,336 to 1,692 in England
  • A study of five European countries found that hepatitis C treatment resulted in overall savings of £435m annually due to improvements in work productivity

The Foundation has produced a document on Financial case for action on liver disease [PDF] to address each of these issues, with the aim of reducing the prevalence of liver disease in the UK and reducing other health and societal costs.

GPs have a significant role to play in the prevention and early detection of liver disease as they work with individual patients. However, to be effective in stemming the rising tide of liver disease, the UK needs a comprehensive, government-led public health strategy.

For more information please view our Liver Disease Toolkit.

Contact

Clinical Innovation and Research Centre: 020 3188 7597
circ@rcgp.org.uk

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