Preventing liver disease with policy measures to tackle alcohol consumption and obesity: the HEPAHEALTH II study.

BACKGROUND AND AIMS: Chronic liver disease (CLD) causes 1.8% of all deaths in Europe, many of them from liver cancer. We estimated the impact of several policy interventions the Netherlands, and Romania.

METHODS: We used a validated microsimulation model to assess seven different policy scenarios in 2022-2030: a Minimum Unit Pricing (MUP) on alcohol of €0.70, an MUP of €1, a volumetric alcohol tax, a sugar-sweetened beverages (SSB) tax, food marketing restrictions, plus two different combinations of these policies compared against an inaction scenario.

RESULTS: All policies reduced the burden of CLD and liver cancer. The largest impact was observed for MUP of €1, which would reduce the cumulative incidence of CLD by 2030 between 7.1% to 7.3% in France, the Netherlands, and Romania compared with inaction. For liver cancer, the corresponding reductions in cumulative incidence were between 4.8% to 5.8%. Implementing a package containing an MUP of €0.70, a volumetric alcohol tax, and an SSB tax would reduce the cumulative incidence of CLD between 4.29% to 4.71% and liver cancer between 3.47% to 3.95% in France, the Netherlands, and Romania. The total predicted reduction in healthcare costs by 2030 was greatest with the €1 MUP scenario, with a reduction for liver cancer costs of €8.18M and €612.49M in the Netherlands and France, respectively.

CONCLUSION: Policy measures tackling primary risk factors for CLD and liver cancer, such as the implementation of an MUP of €1 and/or an MUP of €0.70 plus SSB tax could markedly reduce the number of Europeans with CLD or liver cancer.