Absenteeism and short-term disability associated with breast cancer

Abstract

Few data exist related to the impact of breast cancer on work absenteeism and short-term disability. This retrospective study estimated the extent and costs of breast cancer-associated production loss using a large medical and pharmacy claims database from a US commercially insured population between January 2003 and December 2007. Women aged ≥ 18 years with ≥ 2 breast cancer diagnoses within 90 days were selected. Controls were matched to cases based on index date (first breast cancer diagnosis), age, region, employer, and health insurance type. Outcomes were days absent from work and days with short-term disability. Costs were estimated using daily wage rates. 856 and 2,668 patients were selected for absenteeism and short-term disability, respectively, with a mean age of 49 and 50 years. Average number of absenteeism days was 35 and 21, and short-term disability days were 51 and 5, for cases and controls, respectively, within the post-index year (both P < 0.001). Adjusted incremental costs for absenteeism and short-term disability were $1,911 and $6,157 (P < 0.001), respectively, per breast cancer patient per year. This study suggests that breast cancer is associated with work-related productivity loss within the first year of diagnosis that may be a substantial cost to employers.

Indirect costs associated with metastatic breast cancer

“…In terms of the magnitude of the indirect costs, Fu et al 12 estimated that the indirect costs of overall breast cancer in the US were $4972 in 2009 dollars due to absentiseem and $7199 due to short-term disability per woman within the first year of diagnosis of breast cancer. Our study found lower indirect costs for both sick leave and shortterm disability compared to the Fu et al 12 study: the annual indirect costs per employee were estimated at $1775 due to sick leave/$2383 due to short-term disability among employees with EBC and $3690 due to sick leave/$6166 due to short-term disability for MBC employees, respectively.…”

“…However, there has been little research related to detailing the indirect costs of MBC/BC. Fu et al 12 assessed the incremental indirect costs associated with breast cancer by quantifying the impact of absenteeism (paid time when absent from work) and short-term disability in the US. The authors found that, for the first year of disease post-diagnosis, breast cancer patients incurred nearly twice the amount of absenteeism-related indirect costs and more than 10-times the short-term disability related indirect costs vs a matched control group.…”

Absenteeism and indirect costs during the year following the diagnosis of an operable breast cancer

“…Only a few studies have previously reported these data. Two US retrospective cohort studies found that working patients with BC had significantly longer periods of absenteeism compared to "control" patients (without BC) [9,22]. However, they observed a shorter period of absenteeism in the year following diagnosis when using an HC approach: about 10 days of sick leave and between 25 and 45 days of short-term disability (according to the severity of the disease).…”

“…Data concerning absenteeism and indirect costs are useful for decision-makers when considering cost-of-illness studies or model-based economic evaluations on innovative treatments or screening strategies. Few published studies have focused on the indirect costs of BC and absenteeism, with estimates ranging from $8,068 [9] to $21,086 per patient [10], highlighting the importance of the methodology used and the country in which the study is conducted. In France, only one study has reported the indirect costs associated with adjuvant chemotherapy in BC [11].…”

State-Level Estimates of Cancer-Related Absenteeism Costs

“…For example, across all cancer sites, Finkelstein et al 7 estimated that individuals undergoing active cancer care missed an average of 22.3 more workdays per year than those without cancer. Fu et al 8 estimated that privately employed women with breast cancer had an average of 14 days of absenteeism and 46 days of short-term disability attributable to their breast cancer in the first year after diagnosis. There are at least three reasons that our estimates of cancer-attributable days of absenteeism tended to be lower than the estimates from other studies.…”