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.
Similar content being viewed by others
References
American Cancer Society. Cancer facts & figures 2009. http://www.cancer.org/downloads/STT/500809web.pdf. Accessed 5 Feb 2010
Cancer Stat Fact Sheets. National Cancer Institute. http://seer.cancer.gov/statfacts/html/breast.html. Accessed 23 Feb 2010
A snapshot of breast cancer. National Cancer Institute, 2009 Sept. http://www.cancer.gov/aboutnci/servingpeople/snapshots/breast.pdf. Accessed 1 Mar 2010
Campbell JD, Ramsey SD (2009) The costs of treating breast cancer in the US: a synthesis of published evidence. Pharmacoeconomics 27:199–209
Berkowitz N, Gupta S, Silberman G (2000) Estimates of the lifetime direct costs of treatment for metastatic breast cancer. Value Health 3:23–30
Barron JJ, Quimbo R, Nikam PT, Amonkar MM (2008) Assessing the economic burden of breast cancer in a US managed care population. Breast Cancer Res Treat 109:367–377
Rao S, Kubisiak J, Gilden D (2004) Cost of illness associated with metastatic breast cancer. Breast Cancer Res Treat 83:25–32
Lamerato L, Havstad S, Gandhi S, Jones D, Nathanson D (2006) Economic burden associated with breast cancer recurrence: findings from a retrospective analysis of health system data. Cancer 106:1875–1882
Hensley ML, Dowell J, Herndon JE 2nd, Winer E, Stark N, Weeks JC, Paskett E (2005) Economic outcomes of breast cancer survivorship: CALGB study 79804. Breast Cancer Res Treat 91:153–161
Legorreta AP, Brooks RJ, Leibowitz AN, Solin LJ (1996) Cost of breast cancer treatment. A 4 year longitudinal study. Arch Intern Med 156:2197–2201
Bradley CJ, Yabroff KR, Dahman B, Feuer EJ, Mariotto A, Brown ML (2008) Productivity costs of cancer mortality in the United States: 2000–2020. J Natl Cancer Inst 100:1763–1770
Max W, Sung HY, Stark B (2009) The economic burden of breast cancer in California. Breast Cancer Res Treat 116:201–207
Barnett A, Birnbaum H, Cremieux PY, Fendrick AM, Slavin M (2000) The costs of cancer to a major employer in the United States: a case–control analysis. Am J Manag Care 6:1243–1251
Sasser AC, Rousculp MD, Birnbaum HG, Oster EF, Lufkin E, Mallet D (2005) Economic burden of osteoporosis, breast cancer, and cardiovascular disease among postmenopausal women in an employed population. Women’s Health Issues 15:97–108
Bloom BS (2004) Prevalence and economic effects of depression. Manag Care 13(6 suppl):9–16
Greenberg PE, Kessler RC, Birnbaum HG, Leong SA, Lowe SW, Berglund PA, Corey-Lisle PK (2003) The economic burden of depression in the United States: how did it change between 1990 and 2000. J Clin Psychiatry 64:1465–1475
Zhao Y, Ash AS, Ellis RP, Ayanian JZ, Pope GC, Bowen B, Weyuker L (2005) Predicting pharmacy costs and other medical costs using diagnosis and drug claims. Public Health Rep 116:45–50
United States Bureau Of Labor Statistics. Usual weekly earnings of wage and salary workers by age and sex, 2nd quarter 2009 averages. http://www.bls.gov/news.release/wkyeng.toc.htm. Accessed 10 Nov 2009
United States Bureau Of Labor Statistics. Consumer Price Index. http://www.bls.gov/cpi/cpi_dr.htm. Accessed 15 Jun 2009
Elixhauser A, Steiner C, Harris DR, Coffey RM (1998) Comorbidity measures for use with administrative data. Med Care 36:8–27
Comorbidity software version 3.4 (2009) Rockville, MD: Agency for Healthcare Research and Quality
Box GEP, Cox DR (1964) An analysis of transformation. J R Stat Soc B 26:211–253
Duan N (1983) Smearing estimate: a nonparametric retransformation method. J Am Stat Assoc 78:605–610
Manning WG (1998) The logged dependent variable, heteroscedasticity, and the retransformation problem. J Health Econ 17:283–295
Duan N, Manning WG, Morris CN, Newhouse JP (1983) A comparison of alternative models for the demand for medical care. J Bus Econ Stat 1:115–126
Fu AZ, Kattan MW (2006) Racial and ethnic differences in preference-based health status measure. Curr Med Res Opin 22:2439–2448
McCullagh P, Nelder JA (1989) Generalized linear model. New York, Chapman and Hall
Diehr P, Yanez D, Ash A, Hornbrook M, Lin DY (1999) Methods for analyzing health care utilization and costs. Annu Rev Public Health 20:125–144
Park RE (1966) Estimation with heteroskedastic error terms. Econometrica 34:888
Manning WG, Mullahy J (2001) Estimating log models: to transform or not to transform? J Health Econ 20:461–494
Fu AZ, Wang N (2008) Healthcare expenditure and patient satisfaction: cost and quality from the consumer’s perspective in the United States. Curr Med Res Opin 24:1385–1394
Fu AZ, Qiu Y, Radican L, Wells BJ (2009) Healthcare and productivity costs associated with diabetic patients with macrovascular comorbid conditions. Diab Care 32:2187–2192
Broekx S, Hond ED, Torfs R, Remacle A, Mertens R, D’Hooghe T, Neven P, Christiaens MR, Simoens S (2010) The costs of breast cancer prior to and following diagnosis. Eur J Health Econ. doi:10.1007/s10198-010-0237-3
Gordon L, Scuffham P, Hayes S, Newman B (2007) Exploring the economic impact of breast cancers during the 18 months following diagnosis. Psychooncology 16:1130–1139
Lidgren M, Wilking N, Jönsson B (2007) Cost of breast cancer in Sweden in 2002. Eur J Health Econ 8:5–15
Albain KS, Paik S, van’t Veer L (2009) Prediction of adjuvant chemotherapy benefit in endocrine responsive, early breast cancer using multigene assays. Breast 18(suppl 3):S141–S145
Acknowledgments
This study was supported by funding from sanofi-aventis US. Editorial support was provided by David Pechar, PhD at Phase Five Communications and funded by sanofi-aventis US.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Fu, A.Z., Chen, L., Sullivan, S.D. et al. Absenteeism and short-term disability associated with breast cancer. Breast Cancer Res Treat 130, 235–242 (2011). https://doi.org/10.1007/s10549-011-1541-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10549-011-1541-z