Estimating the National Wage Loss from Cancer in Canada

Hopkins, Rob; Goeree, Ron; Longo, Christopher J.

doi:10.3747/co.v17i2.477

Cited by 29 publications

(14 citation statements)

References 8 publications

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“…Regarding time loss, CRC diagnosis and treatment caused an average wage loss of 1560 CNY, accounting for 3.3% of GDP per capita of China in 2014, which was substantially underestimated. The ratio of wage loss in annual GDP per capita for the only previous study in China was 12.2% [ 22 ], whereas those found in studies in the United States and in Canada were 25.6% [ 26 ] and 289.5% [ 27 ], respectively. This substantial gap could be partly explained by the low labor cost and special healthcare delivery model in China and potentially by methodological differences.…”

Section: Discussionmentioning

confidence: 99%

Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China: a hospital-based, multicenter, cross-sectional survey

et al. 2017

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BackgroundThe increasing prevalence of colorectal cancer (CRC) in China and the paucity of information about relevant expenditure highlight the necessity of better understanding the financial burden and effect of CRC diagnosis and treatment. We performed a survey to quantify the direct medical and non-medical expenditure as well as the resulting financial burden of CRC patients in China.MethodsWe conducted a multicenter, cross-sectional survey in 37 tertiary hospitals in 13 provinces across China between 2012 and 2014. Each enrolled patient was interviewed using a structured questionnaire. All expenditure data were inflated to the 2014 Chinese Yuan (CNY; 1 CNY = 0.163 USD). We quantified the overall expenditure and financial burden and by subgroup (hospital type, age at diagnosis, sex, education, occupation, insurance type, household income, clinical stage, pathologic type, and therapeutic regimen). We then performed generalized linear modeling to determine the factors associated with overall expenditure.ResultsA total of 2356 patients with a mean age of 57.4 years were included, 57.1% of whom were men; 13.9% of patients had stage I cancer; and the average previous-year household income was 54,525 CNY. The overall average direct expenditure per patient was estimated to be 67,408 CNY, and the expenditures for stage I, II, III, and IV disease were 56,099 CNY, 59,952 CNY, 67,292 CNY, and 82,729 CNY, respectively. Non-medical expenditure accounted for 8.3% of the overall expenditure. The 1-year out-of-pocket expenditure of a newly diagnosed patient was 32,649 CNY, which accounted for 59.9% of their previous-year household income and caused 75.0% of families to suffer an unmanageable financial burden. Univariate analysis showed that financial burden and overall expenditure differed in almost all subgroups (P < 0.05), except for sex. Multivariate analysis showed that patients who were treated in specialized hospitals and those who were diagnosed with adenocarcinoma or diagnosed at a later stage were likely to spend more, whereas those with a lower household income and those who underwent surgery spent less (all P < 0.05).ConclusionsFor patients in China, direct expenditure for the diagnosis and treatment of CRC seemed catastrophic, and non-medical expenditure was non-ignorable. The financial burden varied among subgroups, especially among patients with different clinical stages of disease, which suggests that, in China, CRC screening might be cost-effective.

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Section: Discussionmentioning

confidence: 99%

Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China: a hospital-based, multicenter, cross-sectional survey

et al. 2017

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“…Cancer treatment consumes significant public and private expenditures, with the most recent published direct medical costs for cancer care in Canada estimated at CA$7.5 billion for 2012 [ 1 ]. This does not account for indirect costs related to lost income borne by patients and caregivers, for which the only Canadian estimates are from 2009 and suggest burdens between CA$2.95 and CA$3.18 billion [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Patient and family financial burden associated with cancer treatment in Canada: a national study

Longo

Fitch

Loree

et al. 2021

Support Care Cancer

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Goal To determine patient-reported financial and family burden associated with treatment of cancer in the previous 28 days across Canada. Methods A self-administered questionnaire (P-SAFE v7.2.4) was completed by 901 patients with cancer from twenty cancer centres nationally (344 breast, 183 colorectal, 158 lung, 216 prostate) measuring direct and indirect costs related to cancer treatment and foregone care. Monthly self-reported out-of-pocket-costs (OOPCs) included drugs, homecare, homemaking, complementary/ alternative medicines, vitamins/supplements, family care, accommodations, devices, and “other” costs. Travel and parking costs were captured separately. Patients indicated if OOPC, travel, parking, and lost income were a financial burden. Results Mean 28-day OOPCs were CA$518 (US Purchase Price Parity [PPP] $416), plus CA$179 (US PPP $144) for travel and CA$84 (US PPP $67) for parking. Patients self-reporting high financial burden had total OOPCs (33%), of CA$961 (US PPP $772), while low-burden participants (66%) had OOPCs of CA$300 (US PPP $241). “Worst burden” respondents spent a mean of 50.7% of their monthly income on OOPCs (median 20.8%). Among the 29.4% who took time off work, patients averaged 18.0 days off. Among the 26.0% of patients whose caregivers took time off work, caregivers averaged 11.5 days off. Lastly, 41% of all patients had to reduce spending. Fifty-two per cent of those who reduced spending were families earning < CA$50,000/year. Conclusions In our Canadian sample, high levels of financial burden exist for 33% of patients, and the severity of burden is higher for those with lower household incomes.

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“…Other costs associated with non-labor market activities, such as leisure time and informal caregiving, were not considered. Similarly, Hopkins et al conducted a multi-database literature search on the national wage loss from cancer in Canada [ 9 ]. The studies identified in this review also limited their analyses to work-related costs.…”

Section: Discussionmentioning

confidence: 99%

“…In a report conducted by the Public Health Agency of Canada, work-related productivity losses due to cancer were estimated to be $586,000,000 in 2008 [ 8 ]. Subsequently, a review conducted in 2010 identified studies published before 2008 that had estimated wage losses due to cancer [ 9 ] and found that newly diagnosed cancers in Canada generated an average wage loss of $3.18 billion per year. However, these studies only included labor market-related production losses.…”

Section: Introductionmentioning

confidence: 99%

The Indirect Cost Burden of Cancer Care in Canada: A Systematic Literature Review

Iragorri

Oliveira

Essue

2020

Appl Health Econ Health Policy

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Background and objectives Cancer poses a substantial health and economic burden on patients and caregivers in Canada. Previous reviews have estimated the indirect cost burden as work-related productivity losses associated with cancer. However, these estimates require updating and complementing with more comprehensive data that include relevant dimensions beyond labor market costs, such as patient time, lost leisure time and home productivity losses. Methods A systematic review of the literature was conducted to identify studies published from 2006 to 2020 that measured and reported the indirect costs borne by cancer patients and their caregivers in Canada, from the patient, caregiver, employer, and societal perspectives. Study characteristics and cost estimation methods were extracted from relevant studies. Costs estimates were reported and converted to 2020 CAD for the following categories: lost earnings, caregiving time costs, home production losses, patient time (leisure), morbidity-, disability-, premature mortality-related costs, friction costs, and overall productivity losses. A quality assessment of individual studies was conducted for included studies using the Newcastle–Ottawa Assessment Tool. Results In total, 3980 studies were identified, of which 18 Canadian studies met the inclusion criteria for review. One-third of the studies used or developed prediction models, 38% enrolled patient cohorts, and 27% used administrative databases. Over one-third of the studies were conducted at a national level (38%). All studies employed the human capital approach to estimate costs, and 16% also used the friction cost approach. Lost earnings were higher among self-employed patients (43% vs 24% among employees) and females ($8200 vs $3200 for males). Caregiver costs ranged from $15,786 to $20,414 per patient per year. Household productivity losses were estimated to be up to $238,904 per household per year. Patient time (leisure) costs were estimated to be between $13,000 and $18,704 per patient per year. Premature annual mortality costs were estimated to be $2.98 billion overall in Quebec. Friction costs incurred by employers were estimated between $6400 and $23,987 per patient per year. Societal productivity losses associated with cancer were estimated between $75 million to $317 million, annually. Conclusions This review suggests that the indirect cost burden of cancer is considerable from the patient, caregiver, employer, and societal perspectives. This up-to-date review of the literature provides a comprehensive understanding of the indirect cost burden by including non-labor market activity costs and by examining all relevant perspectives. These results provide a strong case for the government and employers to ensure there are supports in place to help patients and caregivers buffer the impact of cancer so they can continue to engage in productive activities and enjoy leisure time. Electronic ...

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Estimating the National Wage Loss from Cancer in Canada

Cited by 29 publications

References 8 publications

Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China: a hospital-based, multicenter, cross-sectional survey

Expenditure and financial burden for the diagnosis and treatment of colorectal cancer in China: a hospital-based, multicenter, cross-sectional survey

Patient and family financial burden associated with cancer treatment in Canada: a national study

The Indirect Cost Burden of Cancer Care in Canada: A Systematic Literature Review

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