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Discussion
countries may be required to ensure health systems are able to cope with demand.
Evaluating the impact of the COVID-19 pandemic on these projections will be possible as
more data become available.
Estimating economic costs that arise from outside of the healthcare system, as a result of
lost productivity, can also provide valuable information to aid policy decisions regarding the
allocation of resources. Estimated costs of lost output due to digestive disease related
morbidity and premature mortality as a percentage of GDP were, on average, 0.22% and
0.25%, respectively across the 31 countries in 2019. Indirect costs can sometimes be
overlooked by policymakers when justifying the prioritisation of resources,122 however as
these results suggest, indirect costs due to digestive diseases in Europe are considerable.
Differences between countries in the economic cost of lost output due to digestive diseases,
largely reflect the number and age-distribution of deaths and years of healthy life lost due to
disability. Some countries experience relatively high economic costs even when their overall
disease burden is relatively low, because these countries tend to have a higher prevalence of
specific conditions that particularly affect people of working age. For example, Italy and the
UK have a high cost of lost output due to digestive disease related morbidity, which is partly
due to a higher burden of gallbladder and biliary diseases that tend to have a high prevalence
amongst those of working age.
To demonstrate the benefits of reducing digestive disease related premature mortality from
a human capital perspective, if, across the 31 countries, digestive disease related premature
mortality were reduced by 25%, 50% or 75% in 2019, the estimated savings from the
prevention of productivity losses would have amounted to a total of €11.4, €22.8 or €34.2
billion, respectively. Reducing digestive disease related premature mortality by 25% in 2019
would have resulted in estimated savings of approximately €2.97 billion in Germany, €1.77
billion in the UK, and €1.4 billion in France, for example. These enormous sums are to a large
extent a reflection of the high mortality attributable to chronic liver diseases amongst
individuals of working age in Europe.139
Opportunities to reduce the burden
Public health gains from the implementation of new policies and interventions designed to
reduce disease burden can take long periods of time to be realised, however the overall lack
of progress over the last two decades in reducing the incidence of digestive disorders points
to the need for greater adoption of effective preventative strategies.
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