Preventing liver disease with policy measures to tackle alcohol consumption and obesity



Chronic liver disease (CLD) causes 1.8% of all deaths in Europe. Without policies to mitigate harmful alcohol consumption and obesity, that proportion will continue to increase. This study aims to estimate the impact of policy interventions targeting alcohol and obesity on the incidence of CLD and primary liver cancer in France, the Netherlands, and Romania.
A validated and peer-reviewed microsimulation model was employed using data from online databases and published literature. Static and dynamic trends in alcohol consumption and body mass index (BMI) respectively were projected from 2022 to 2030. We modeled the incidence of CLD and liver cancer under three policy scenarios versus an inaction scenario. The policies were 1€ minimum unit pricing (MUP) on alcohol; a combination of 0.7€ MUP and a sugar sweetened beverage (SSB) tax; and a combination of 0.7€ MUP, SSB tax, and a volumetric tax on alcohol.
All policies had an important impact ranging from a 2% to 7% reduction in annual incidence of chronic liver disease and liver cancer by 2030. The 1€ MUP policy had the largest predicted impact: In the three countries combined, that policy would result in 11,550 fewer cases of CLD and 7,921 fewer cases of liver cancer by 2030. Policy interventions combining a €0.7 MUP, an SSB tax, and a volumetric tax on alcohol would prevent nearly as many cases: 7,317 cases of CLD and 5,390 cases of liver cancer by 2030 compared with the inaction scenario.
In conclusion, we can reduce the number of Europeans who develop chronic liver disease or liver cancer by up to 7% before 2030 if we introduce a €1 MUP on alcohol, or we introduce complementary public health policies targeting alcohol consumption and obesity.
This study has been supported by an unrestricted education grant from Bristol-Myers Squibb and Gilead. Bristol-Myers Squibb and Gilead have had no input into EASL content.