Estimating productivity losses for cancer patients and caregivers of cancer patients

• Published in: Journal of clinical oncology Vol. 38; no. 15_suppl; p. e19381
• Main Authors: Chiu, Kevin, MacEwan, Joanna P., Bognar, Katalin, Peneva, Desi, May, Suepattra Grace, Zhao, Lauren, Yong, Candice, Amin, Suvina, Bolinder, Bjorn, Batt, Katharine, Baumgardner, James
• Format: Journal Article
• Language: English
• Published: 20.05.2020
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2020.38.15_suppl.e19381

Abstract only e19381 Background: Although cancer is a leading cause of illness in the United States, its true impact on productivity is poorly understood. Traditional approaches to capturing health-related productivity loss—e.g., the human capital method—focus on patients’ foregone wages, overlooking fringe benefits and the impacts incurred by caregivers and co-workers. Thus, the value of lost productivity is often underestimated. We sought to comprehensively estimate productivity loss incurred by working-age cancer patients and unpaid caregivers in the United States. Methods: We conducted a cross-sectional survey study of (i) non-small cell lung cancer (NSCLC) and breast cancer (BC) patients, and (ii) unpaid caregivers. To measure loss associated with absenteeism and presenteeism, participants reported pre- and post-cancer diagnosis income, hours worked, and time to complete tasks. The “multiplier effect” method was used to measure productivity loss incurred by co-workers due to patient or caregiver absenteeism and/or presenteeism. Exploratory multivariable analyses controlled for cancer type, stage, age, time since diagnosis, oncogene mutation status, and industry sector. Results: A total of 404 participants (104 BC, 100 NSCLC patients; 100 BC, 100 NSCLC caregivers) completed the surveys. Of these, 319 participants (162 BC, 157 NSCLC) who worked ≥40 weeks in the year pre-diagnosis and who did not transition from part- to full-time work after diagnosis were included in the analysis. Over a third of the NSCLC (33%) and BC (43%) patients left the workforce after diagnosis. For patients, estimated mean annual productivity loss equaled $123,792 (144% of mean income pre-diagnosis) for NSCLC and $123,502 (209% of mean income pre-diagnosis) for BC. For caregivers, the estimated mean annual productivity loss was $90,421 (108% of mean income pre-diagnosis) for NSCLC and $143,839 (190% of mean income pre-diagnosis) for BC. Exploratory analyses also found that patient age and stage at diagnosis were positively correlated with a greater absenteeism effect. Conclusions: This study found that traditional approaches, such as the human capital method, significantly underestimate productivity loss in cancer patients and caregivers. Holistic approaches that include lost wages, fringe benefits, and teamwork effects, are better approaches to understanding the amplified impact cancer can have for patients, caregivers, and co-workers.