Financial Case For Action On Liver Diseases. Escalating Costs For Alcohol Misuse, Obesity And Viral Hepatitis
Executive summary
Liver disease has grown to become one of the most common causes of premature death in the UK and its burden continues to escalate. 62,000 years of working life are lost to liver disease every year and its impact on the poorest in our society is disproportionally severe, contributing to the widening of socioeconomic health inequalities in the UK.
Worsening liver disease health outcomes could be reversed through concerted preventive action to tackle its main causes: alcohol misuse, obesity and viral hepatitis. Voluntary agreements with the food and drinks and alcohol industries have proved ineffective.
Through this paper, the Foundation for Liver Research seeks to make the financial case for public health action in these areas and urges the implementation of targeted measures recommended by the independent Lancet Commission on Liver Disease. This paper summarises the escalating financial costs to the health and care system as well as the wider societal costs related to the three lifestyle-related risk factors.
Recommendations
- Minimum unit price (MUP) for alcohol: The first five years of a 50p MUP would generate £1.1bn of savings in total direct costs, whilst the total societal value would be worth £3bn. Scotland is awaiting the conclusion of a legal challenge on MUP led by the Scotch Whisky Association, whilst Wales also intends to legislate for MUP
- Re-introduce the alcohol duty escalator: A duty escalator 2% above inflation would result in a total saving of £226.9m to the NHS over a five year period
- New higher duty band for cider based on alcohol content between 5.5% and 7.5%: A 500ml can of cider at 7.5% ABV generates 19p duty, compared with 69p on a can of beer of equivalent size and strength. The Republic of Ireland has a higher rate of tax for cider above 6% to mitigate its harmful impact
- Restrict trading hours for off-licence to 10am-10pm and limit alcohol availability for on-licence after midnight: Australia has demonstrated large reductions in non-domestic assault by restricting trading hours
- Stronger regulation of alcohol marketing and advertising: Removing exposure to TV advertising for 11-18 year olds would lead to a fall of 9% in alcohol consumption
Financial case
The Foundation for Liver Research builds its case on the basis of figures from a range of sources, which show among other things that:
- The societal cost of alcohol in England and Wales has been estimated between £21 billion (UK Government Cabinet Office) and £52 billion (Public Health England)
- Without further action, between 2017 and 2022, alcohol-related illness in England is projected to cause 63,000 deaths and cost the NHS £17 billion (University of Sheffield / Cancer Research UK)
- 167,000 years of working life were lost in England in 2015 (Public Health England)
- 57,940 claimants of government sickness/disability benefits had alcohol misuse as their primary medical condition (Department of Work & Pensions)
- Alcohol-related crime has a social cost of £13 billion a year in England and Wales (Home Office)
Professor Roger Williams, Director of the Foundation for Liver Research, and Chairman of the Lancet Commission on Liver Disease argued:
Liver disease is a public health crisis that has been steadily unfolding before our eyes for a number of years now and the Government will have to take robust public health action if its main causes (alcohol misuse, obesity and viral hepatitis) are to be controlled. Our new report strengthens the argument for intervention by revealing the full and alarming extent of the financial costs associated with inaction in these areas and setting out the economic benefits of addressing these risk factors.
Three years ago, the Lancet Commission on Liver Disease created a blueprint for improvement, supported by the clinical community, setting out a range of targeted measures to reduce the burden of ill health in these areas. Yet we are still missing prioritisation, funding and drive to implement the Commission’s recommendations. We urge the Government to take immediate steps to halt and reverse the crisis in liver disease.”
