The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute, Department of Pharmacy, University of Washington, Seattle.
J Manag Care Spec Pharm. 2024 Jun;30(6):572-580. doi: 10.18553/jmcp.2024.30.6.572.
New cancer diagnoses are associated with employment decrease, workplace absenteeism, and attributable costs to employers.
To estimate the workplace productivity loss in the year following a new diagnosis of early-, intermediate-, or advanced-stage hepatocellular carcinoma (HCC) in commercially insured US adults.
We conducted a retrospective cohort study using Merative MarketScan commercial claims to identify incident HCC diagnoses from 2010 to 2020. Patients were stratified into early-, intermediate-, or advanced-stage cohorts based on presence of secondary malignancy codes or first treatment received. Mean workdays lost and attributable cost in the year following a new diagnosis were calculated using the Kaplan-Meier sample averages to account for censoring. An exploratory analysis was conducted on subgroups in the early and advanced cohorts to assess productivity loss in patients with and without treatment.
Mean workdays lost in the year following a new HCC diagnosis among the early, intermediate, and advanced cohorts was 22.6 days (95% CI = 16.0-29.8), 17.4 days (95% CI = 11.9-23.2), and 19.5 days (95% CI = 15.6-23.6), respectively. Corresponding indirect costs were $6,031(95% CI = $4,270-$7,953), $4,644 (95% CI = $3,176-$6,192), and $5,204 (95% CI = $4,163-$6,298). Early-stage patients without a liver transplant and advanced-stage patients who received systemic therapy had 19.7 (95% CI = 12.7-27.4) and 22.0 (95% CI = 16.6-27.7) mean workdays lost, respectively.
Productivity loss varies by stage and appears to be higher in early-stage patients who receive more intensive treatments in the first year following a new HCC diagnosis.
新癌症诊断与就业减少、工作场所缺勤和雇主应承担的成本有关。
估计新诊断为早期、中期或晚期肝细胞癌(HCC)的美国商业保险成年人在诊断后一年内的工作场所生产力损失。
我们使用 Merative MarketScan 商业索赔进行了一项回顾性队列研究,以确定 2010 年至 2020 年期间 HCC 的新诊断病例。根据是否存在二级恶性肿瘤代码或首次接受的治疗方法,患者被分为早期、中期或晚期队列。使用 Kaplan-Meier 样本平均值计算新诊断后一年内的平均工作日损失和应归因成本,以考虑删失。对早期和晚期队列中的亚组进行了探索性分析,以评估治疗与未治疗患者的生产力损失。
早期、中期和晚期 HCC 诊断后一年内的平均工作日损失分别为 22.6 天(95%CI=16.0-29.8)、17.4 天(95%CI=11.9-23.2)和 19.5 天(95%CI=15.6-23.6)。相应的间接成本分别为 6031 美元(95%CI=4270 美元-7953 美元)、4644 美元(95%CI=3176 美元-6192 美元)和 5204 美元(95%CI=4163 美元-6298 美元)。未接受肝移植的早期患者和接受系统治疗的晚期患者的平均工作日损失分别为 19.7(95%CI=12.7-27.4)和 22.0(95%CI=16.6-27.7)。
生产力损失因阶段而异,在新诊断 HCC 后第一年接受更强化治疗的早期患者中似乎更高。