How an integrated care model could transform liver disease outcomes in Asia Pacific

Almost every family in the Asia-Pacific region knows someone affected by liver disease — but could a new, integrated care model help detect hepatitis in time to prevent progression to liver cancer?

The silent killer: early detection of liver disease is crucial

In Thailand, liver disease is one of the starkest challenges to public health. Hepatitis B (HBV) viruses affect around 5% of the population (2-3 million people), and Hepatitis C (HCV) viruses affect around 0.4% (300,000 people)¹. Both are preventable for the most part — but if they’re left untreated, can progress to cirrhosis and ultimately, liver cancer (HCC).

Even though HCC is preventable, it’s still the number one cause of death in Thailand. People are often unaware of the link between hepatitis and HCC. The disease accounts for over 26,000 deaths annually² — primarily as a result of late detection.

And after detection of possible HCC, patients face an agonising six-month wait for high-cost ultrasound scans. This creates major bottlenecks that cause delayed or even missed diagnoses. As a result, the survival rate after diagnosis is just 13%³.

To improve liver health outcomes at scale and reduce the disease’s heavy societal burden, one thing is clear: a new approach to detection is needed.

LEAP: Thailand’s integrated approach to combat liver disease

Thailand’s Liver Ecosystem Advancement Program (LEAP) is a coordinated, first-of-its-kind response to the public health challenge. It combines early screening, digital health, integrated care, and government-backed innovation to improve access to care and reduce wait times for diagnosis.

Case study: the Chantaburi EZ Liver Network

A pilot project established by Roche and the EZ liver network — a Chantaburi province initiative under the LEAP program — shows why this approach works so well. It brings together medical health volunteers, lab technicians, preventative physicians, gastroenterologists, radiologists, hepatobiliary surgeons and medical oncologists.

Working together as one, these clinicians can streamline patients’ screening and treatment journeys. That cross-functional collaboration is what makes the EZ liver network unique; it’s a fully integrated liver care ecosystem.

The goal is to screen more of the high-risk population for liver disease (individuals currently infected with hepatitis B or C), as well as treating hepatitis, monitoring HCC and treating HCC aiming to cure.

Through education campaigns and digital health tools, the pilot has expanded access and engagement with both proactive and reactive screening, even in remote areas — and it has been a major success.

18,000 people have been screened and 1,566 were identified as new Hepatitis B patients — 80% of whom received treatment. HBV doesn’t typically present with symptoms, so without screening, these patients wouldn’t be aware of their condition or their risk of progression to more serious liver disease, and wouldn’t have been treated.

And in some individuals, liver cirrhosis or early-stage liver cancer was detected. The EZ clinic ensured they received a liver ultrasound within just six weeks.
This, in turn, led to faster referrals for potential curative surgeries or microwave ablation, reducing patients’ treatment wait times from six months to less than two months.

Chantaburi resident Mr Sutat Liusuwan, 71, is one such beneficiary. “I used to have hepatitis C and joined the EZ Liver Clinic program,” he says. 

“During a follow-up, the doctor told me my results were abnormal and I might have a tumor. It turned out to be small, but I needed a microwave ablation. When I heard it would cost 10,000–20,000 baht and [I] wasn’t covered, I felt hopeless because I didn’t have the money. 

“Thankfully, the hospital used donations from the program to cover the cost. 

After treatment, I felt better, my results improved, and there’s been no sign of the tumor returning. I’ve also received free check-ups and treatment.”

Now, the network aims to target everyone at risk over the age of 35 in Chanthaburi province, screening over 1 million people and securing continuous government support and funding, including reimbursement of microwave ablation and targeted immunotherapy. It has combined liver care functions into a cohesive system to enhance the management and surveillance of hepatitis and progression to HCC.

A collaborative blueprint for liver health across Asia Pacific

As other Asia Pacific nations grapple with rising HCC rates, Thailand’s integrated strategy offers a powerful, practical model for regional adaptation.

The EZ liver network and wider LEAP program show why knowledge transfer between healthcare leaders, clinicians across disciplines, policymakers and innovators is so vital; the clinic’s success couldn’t have been achieved without collaboration.

Partnerships with industry, meanwhile, can also boost resource availability, technology transfer and knowledge sharing. The successful pilot has been a collaborative effort from stakeholders across the healthcare system. Now, Roche is bringing together healthcare professionals, experts and policymakers from the National Health Security Office to scale up the project with more sites across Thailand.

This means we can act earlier in areas where we can make the biggest impact — addressing the critical problem of delayed or missed disease diagnoses even in underserved regions.

As the EZ liver network’s Dr. Passakorn Wanchaijiraboon puts it, “We’ve learnt a lot from working at the EZ clinic, particularly the importance of teamwork that centres around the patient’s benefit.

“Collaborating with various government agencies was crucial, as well as with the private sector as a catalyst, allowing each organisation a platform to share their experiences. Their support was pivotal to establishing and expanding the pilot project, facilitating knowledge transfer to other areas, aiding in developing similar initiatives.”

And for Mr Liusuwan, the EZ liver network’s approach has allowed him to enjoy more years with his family in better health. He hasn’t looked back. “Joining the program has had a big impact on my life and my family’s. My message to other Thais is: if you know you have the disease, get treated early.”

“And to doctors and nurses in other hospitals — please make hepatitis screening and EZ Liver Clinics available in more provinces, like here at Phrapokklao Hospital. I want this program everywhere in the country.”

The way forward is clear. To succeed in improving health outcomes for millions more people like Mr Liusuwan, we call on healthcare leaders, governments and innovators across Asia-Pacific to prioritise earlier liver screening in an integrated care model, fostering collaboration between diverse stakeholders and forging strong partnerships. 

Together, we can transform health outcomes and drive greater health equity for millions across Asia Pacific. The time to act is now.
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