Chiu Kevin, MacEwan Joanna P, May Suepattra G, Bognar Katalin, Peneva Desi, Zhao Lauren M, Yong Candice, Amin Suvina, Bolinder Bjorn, Batt Katharine, Baumgardner James R
PRECISIONheor, New York, NY, USA.
AstraZeneca, Inc., Gaithersburg, MD, USA.
MDM Policy Pract. 2022 Aug 3;7(2):23814683221113846. doi: 10.1177/23814683221113846. eCollection 2022 Jul-Dec.
Traditional approaches to capturing health-related productivity loss (e.g., the human capital method) focus only on the foregone wages of affected patients, overlooking the losses caregivers can incur. This study estimated the burden of productivity loss among breast cancer (BC) and non-small-cell lung cancer (NSCLC) patients and individuals caring for such patients using an augmented multiplier method. A cross-sectional survey of BC and NSCLC patients and caregivers measured loss associated with time absent from work (absenteeism) and reduced effectiveness (presenteeism). Respondents reported pre- and postcancer diagnosis income, hours worked, and time to complete tasks. Exploratory multivariable analyses examined correlations between respondents' clinical/demographic characteristics-including industry of employment-and postdiagnosis productivity. Of 204 patients (104 BC, 100 NSCLC) and 200 caregivers (100 BC, 100 NSCLC) who completed the survey, 319 participants (162 BC, 157 NSCLC) working ≥40 wk/y prediagnosis were included in the analysis. More than one-third of the NSCLC (33%) and BC (43%) patients left the workforce postdiagnosis, whereas only 15% of caregivers did. The traditional estimate for the burden of productivity loss was 66% lower on average than the augmented estimate (NSCLC patients: 60%, BC patients: 69%, NSCLC caregivers: 59%, and BC caregivers: 73%). Although patients typically experience greater absenteeism, productivity loss incurred by caregivers is also substantial. Failure to account for such impacts can result in substantial underestimation of productivity gains novel cancer treatments may confer by enabling patients and caregivers to remain in the workforce longer. Our results underscore the importance of holistic approaches to understanding this impact on both patients and their caregivers and accounting for such considerations when making decisions about treatment and treatment value.
Cancer can have a profound impact on productivity. This study demonstrates how the disease affects not only patients but also the informal or unpaid individuals who care for patients.An augmented approach to calculating health-related productivity loss suggests that productivity impacts are much larger than previously understood.A more comprehensive understanding of the economic burden of cancer for both patients and their caregivers suggests the need for more support in the workplace for these individuals and a holistic approach to accounting for these impacts in treatment decision making.
传统的衡量与健康相关的生产力损失的方法（如人力资本法）仅关注受影响患者放弃的工资，而忽视了照顾者可能遭受的损失。本研究使用一种增强乘数法估计了乳腺癌（BC）和非小细胞肺癌（NSCLC）患者以及照顾此类患者的个人的生产力损失负担。对BC和NSCLC患者及照顾者进行的横断面调查测量了与缺勤（旷工）和效率降低（出勤主义）相关的损失。受访者报告了癌症诊断前后的收入、工作小时数以及完成任务的时间。探索性多变量分析研究了受访者的临床/人口统计学特征（包括就业行业）与诊断后生产力之间的相关性。在完成调查的204名患者（104名BC患者，100名NSCLC患者）和200名照顾者（100名BC患者的照顾者，100名NSCLC患者的照顾者）中，319名在诊断前每年工作≥40周的参与者（162名BC患者，157名NSCLC患者）被纳入分析。超过三分之一的NSCLC患者（33%）和BC患者（43%）在诊断后离开了劳动力市场，而照顾者中只有15%离开了。传统的生产力损失负担估计平均比增强估计低66%（NSCLC患者：60%，BC患者：69%，NSCLC患者的照顾者：59%，BC患者的照顾者：73%）。尽管患者通常旷工情况更严重，但照顾者造成的生产力损失也相当大。未能考虑到此类影响可能会导致对新的癌症治疗方法通过使患者和照顾者能够更长时间留在劳动力市场而可能带来的生产力提高的严重低估。我们的结果强调了采用整体方法来理解这种对患者及其照顾者的影响以及在做出治疗和治疗价值决策时考虑此类因素的重要性。
癌症会对生产力产生深远影响。本研究表明该疾病不仅影响患者，还影响照顾患者的非正式或无薪个人。一种计算与健康相关的生产力损失的增强方法表明生产力影响比以前理解的要大得多。对癌症给患者及其照顾者带来的经济负担有更全面的理解表明需要在工作场所为这些人提供更多支持，并在治疗决策中采用整体方法来考虑这些影响。
