Cost Burden of Alcohol-Related Liver Disease to Skyrocket



The indirect and direct costs of alcohol-associated liver disease (ALD) could sap the US economy of $880 billion from 2022 to 2040, a new analysis shows.


  • Researchers estimated the current and projected economic burden of direct healthcare spending, productivity loss, and premature mortality due to ALD in the US population.

  • They used a previously validated microsimulation model of alcohol consumption and ALD with model parameters estimated from publicly available data sources.

  • They incorporated the impact of changes in drinking patterns induced by COVID-19.


  • Over roughly the next 18 years, ALD in the United States is projected to cost $355 billion in direct healthcare-related costs and $525 billion in lost labor and economic consumption.

  • On an annual basis, ALD-associated costs are projected to increase 118% — from $31 billion in 2022 to $66 billion in 2040.

  • Costs related to ALD in women could rise from 29% of total annual ALD-associated expenditures in 2022 to 43% in 2040.

  • The rise in total care costs is largely predicated on increases in the cost of care for decompensated cirrhosis. The annual costs attributable to decompensated cirrhosis were $6.2 billion in 2022 and are projected to increase by 185%, to $17.7 billion, in 2040.


“Increased consumption of alcohol in the US population, especially in females, will cause a steep rise in the economic burden of ALD in the United States. These findings highlight the need for planners and policymakers to plan for the increased impact of liver disease in the United States,” the authors write.


The study, with first author Jovan Julien, PhD, Institute for Technology Assessment, Massachusetts General Hospital, Boston, was published online August 21 in the American Journal of Gastroenterology. Funding was provided by the American Cancer Society and the National Institutes of Health.


Data on drinking transitions among the general population are limited. Although increases in alcohol consumption associated with the initial COVID-19 outbreak were modeled, the models did not account for future changes in disease progression due to the endemic spread of COVID-19, which has been shown to negatively affect liver health.


The authors have disclosed no relevant financial relationships.

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