Despite improvements in prognosis and survival of patients with human epidermal growth factor receptor 2 (HER)-positive metastatic breast cancer, time lost from work remains high in this population, and it is associated with a substantial economic burden for U.S. employers, according to a study, the results of which were presented during AMCP Nexus 2020 Virtual in a poster presentation titled “Workplace Productivity Loss and Associated Indirect Costs among Patients with HER2+ Metastatic Breast Cancer in the United States.”
Researchers conducted a retrospective analysis via the OptumHealth database from 1999 to 2017. They compared days of work loss and associated costs between patients with HER2+ metastatic breast cancer (n=265) and employees without cancer (controls; n=265). Patients who received anti-HER2 treatment after first metastatic breast cancer diagnosis and had available earning and disability data were matched 1:1 to a control group based on demographics, health insurance plan, and the start and end date of availability of disability data.
The number of days covered by disability claims and days lost from work due to medical conditions resulting in health resource utilization were summarized from the first metastatic breast cancer diagnosis to the end of follow-up. Work loss due to health resource utilization was calculated by assuming one day of missed work for inpatient days, days with visit to emergency department or outpatient infusion service, and half day of missed work for other outpatient visits. The associated indirect cost was comprised of disability claims and cost of health resource utilization-related work loss estimated by the product of patient’s daily earnings and days of health resource utilization-related work loss.
After a median follow-up of 18.3 months, patients with HER2+ metastatic breast cancer were more likely to have disability claims (30% vs. 5%), more disability days (36 vs. 4 days), health resource utilization-related work loss days (39 vs. 4 days), and total days of work loss (75 vs. 8 days; P<0.01 for all) per person-year than controls.
The average annual costs associated with work loss were significantly higher for patients with HER2+ metastatic breast cancer than controls ($15,771 vs. $1,606), with higher annual cost due to disability ($4,923 vs. $662) and heath resource utilization-related work loss ($10,847 vs. $944; P<0.01 for all).
“Based on our knowledge, this is the first study to examine work loss outcomes for patients with HER2+ metastatic breast cancer. The results underscore the unmet need for reducing workplace productivity loss for working [patients with] HER2+ metastatic breast cancer,” the researchers concluded.
The study is limited by its inclusion of only privately insured employees who were 65 years or younger and employed during the study period, thus the findings may not be generalizable to a broader patient cohort.
The study was sponsored by Daiichi-Sankyo and AstraZeneca.
Lin F, Pavilack M, Shi S, Xie J, Ionescu-Ittu R, Selvam S, et al. Workplace Productivity Loss and Associated Indirect Costs among Patients with HER2+ Metastatic Breast Cancer in the United States. Poster C27. AMCP Nexus 2020 Virtual.