Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan.
Chugai Pharmaceutical Co., Ltd, Tokyo, Japan.
J Med Econ. 2020 Dec;23(12):1570-1578. doi: 10.1080/13696998.2020.1839234. Epub 2020 Nov 5.
Patients with cancer experienced reduced health-related quality-of-life (HRQoL), increased work productivity and activity impairment (WPAI), and indirect costs. With the current emphasis on economic evaluation of health technology in Japan, it is important to understand how indirect costs correlate with HRQoL and patient characteristics. It is also crucial to assess the patient characteristics associated with the HRQoL, WPAI, and indirect costs among patients with any types of cancer.
This cross-sectional study used data from the 2017 Japan National Health and Wellness Survey (NHWS). Respondents self-reported their HRQoL and WPAI by answering validated SF-12v2 and WPAI questionnaires, respectively. Indirect costs were derived using the human capital method. Correlation between HRQoL components and indirect costs were assessed using Spearman's rank-order correlation. Correlation between patient characteristics and HRQoL, WPAI, and indirect costs were analyzed using generalized linear models.
A total of 1,540 patients with any types of cancer, 254 with breast cancer, and 144 with colorectal cancer were included in the analyses. There was significant negative correlation between the indirect costs and HRQoL components among patients with any types of cancer. Patients with lower comorbid burden, higher household income, employed, married, or living with partner, never smokers, and exercised tended to have higher HRQoL. Being never smokers, having lower comorbid burden, normal weight, and exercised were associated with lower WPAI measures. Additionally, patients who were older, not married, not obese, and not smoking tended to incur lower indirect costs.
The negative correlation between HRQoL and indirect costs among patients with cancer emphasized the needs to improve health outcomes and reduce indirect costs of patients. The factors associated with cancer burden identified in this study provide insights to allow targeted intervention to improve HRQoL and lessen the WPAI and indirect cost among cancer patients in Japan.
癌症患者的健康相关生活质量（HRQoL）降低，工作生产力和活动障碍（WPAI）增加，以及间接成本增加。鉴于日本目前对卫生技术的经济评估重点，了解间接成本与 HRQoL 以及患者特征之间的相关性非常重要。评估癌症患者的 HRQoL、WPAI 和间接成本与患者特征之间的相关性也至关重要。
本横断面研究使用了 2017 年日本国家健康与健康调查（NHWS）的数据。受访者通过回答经过验证的 SF-12v2 和 WPAI 问卷，分别报告了他们的 HRQoL 和 WPAI。使用人力资本法得出间接成本。使用 Spearman 秩相关评估 HRQoL 成分与间接成本之间的相关性。使用广义线性模型分析患者特征与 HRQoL、WPAI 和间接成本之间的相关性。
共纳入 1540 名患有任何类型癌症的患者，其中 254 名患有乳腺癌，144 名患有结直肠癌。患有任何类型癌症的患者的间接成本与 HRQoL 成分之间存在显著的负相关。合并症负担较低、家庭收入较高、就业、已婚或与伴侣同住、从不吸烟且经常锻炼的患者往往具有较高的 HRQoL。从不吸烟、合并症负担较低、体重正常且经常锻炼与较低的 WPAI 措施相关。此外，年龄较大、未婚、不肥胖且不吸烟的患者往往间接成本较低。
癌症患者 HRQoL 与间接成本之间的负相关强调了改善健康结果和降低患者间接成本的必要性。本研究确定的与癌症负担相关的因素为改善日本癌症患者的 HRQoL 并减轻 WPAI 和间接成本提供了有针对性干预的思路。
