Abstract
BACKGROUND: Cirrhosis and other chronic liver diseases are the 12th leading cause of death globally and impose a substantial economic burden. Estimating the macroeconomic burden and distribution can provide a policy rationale for the prevention and treatment of these issues. We aimed to estimate and project the macroeconomic burden of cirrhosis and other chronic liver diseases in 190 countries and territories, as well as their distribution across world regions. METHODS: We calculated the macroeconomic burden of cirrhosis and other chronic liver diseases in 190 countries using a health-augmented macroeconomic model that accounts for the impact of morbidity and mortality on labor supply, age differences in education and experience among those affected by cirrhosis and other chronic liver diseases, and reduced investment due to the shifting of costs of these disease-related treatments from savings. RESULTS: Our findings suggest that cirrhosis and other chronic liver diseases will cost the world economy INT$ 2.649 trillion (2.502-2.827) in 2021-2050. The United States has the largest economic burden of cirrhosis and other chronic liver diseases, followed by China and India. Although low- and middle-income countries have the highest health burdens (91.4% of the global disability-adjusted life years), their share of the economic burden of cirrhosis is only 57.1% of the global loss. CONCLUSIONS: The macroeconomic burden of cirrhosis and other chronic liver diseases is sizeable and distributed unequally across countries and world regions. Our study emphasizes the need for greater investment globally in controlling cirrhosis and other chronic liver diseases and their associated health and economic burdens.