The cost of lost productivity due to premature cancer-related mortality: an economic measure of the cancer burden

BMC Cancer

Paul A Hanly¹  Linda Sharp² 

[1] National College of Ireland, Mayor Street, Dublin 1, Ireland

[2] National Cancer Registry Ireland, Cork Airport Business Park, Kinsale Road, Cork, Ireland

关键词: Ireland;    Economic burden;    Cancer;    Years of life lost;    Productivity costs;   

Others  :  858933
DOI  :  10.1186/1471-2407-14-224

 received in 2013-11-01, accepted in 2014-03-14,  发布年份 2014

【 摘 要 】

Background

Most measures of the cancer burden take a public health perspective. Cancer also has a significant economic impact on society. To assess this economic burden, we estimated years of potential productive life lost (YPPLL) and costs of lost productivity due to premature cancer-related mortality in Ireland.

Methods

All cancers combined and the 10 sites accounting for most deaths in men and in women were considered. To compute YPPLL, deaths in 5-year age-bands between 15 and 64 years were multiplied by average working-life expectancy. Valuation of costs, using the human capital approach, involved multiplying YPPLL by age-and-gender specific gross wages, and adjusting for unemployment and workforce participation. Sensitivity analyses were conducted around retirement age and wage growth, labour force participation, employment and discount rates, and to explore the impact of including household production and caring costs. Costs were expressed in €2009.

Results

Total YPPLL was lower in men than women (men = 10,873; women = 12,119). Premature cancer-related mortality costs were higher in men (men: total cost = €332 million, cost/death = €290,172, cost/YPPLL = €30,558; women: total cost = €177 million, cost/death = €159,959, cost/YPPLL = €14,628). Lung cancer had the highest premature mortality cost (€84.0 million; 16.5% of total costs), followed by cancers of the colorectum (€49.6 million; 9.7%), breast (€49.4 million; 9.7%) and brain & CNS (€42.4 million: 8.3%). The total economic cost of premature cancer-related mortality in Ireland amounted to €509.5 million or 0.3% of gross domestic product. An increase of one year in the retirement age increased the total all-cancer premature mortality cost by 9.9% for men and 5.9% for women. The inclusion of household production and caring costs increased the total cost to €945.7 million.

Conclusion

Lost productivity costs due to cancer-related premature mortality are significant. The higher premature mortality cost in males than females reflects higher wages and rates of workforce participation. Productivity costs provide an alternative perspective on the cancer burden on society and may inform cancer control policy decisions.

【 授权许可】

   
2014 Hanly and Sharp; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Jemal A, Bray F, Centre MM, Ferlay J, Ward E, Forman D: Global cancer statistics. CA Cancer J Clin 2011, 61:69-90.
• [2]Verdecchia A, Guzzinati S, Francisci S, De Angelis R, Bray F, Allemani C, Tavilla A, Santaquilani M, The EUROCARE Working Group: Survival trends in European cancer patients diagnosed from 1988 to 1999. Eur J Cancer 2009, 45:1042-1066.
• [3]Soerjomataram I, Lortet-Tieulent J, Parkin DM, Ferlay J, Mathers C, Forman D, Bray F: Global burden of cancer in 2008: a systematic analysis of disability-adjusted life-years in 12 world regions. Lancet 2012, 380:1840-1850.
• [4]Economist Intelligence Unit: Breakaway: the global burden of cancer - challenges and opportunities. [http://www.livestrong.org/What-We-Do/Our-Approach/Reports-Findings/Economic-Impact-Report webcite]
• [5]Morris S, Cox B, Bosanquet N: Cost of skin cancer in England. Eur J Health Econ 2009, 10:267-273.
• [6]Broekx S, Hond E, Torfs R, Remacle A, Mertens R, D'Hooghe T, Neven P, Christiaens MR, Simoens S: The costs of breast cancer prior to and following diagnosis. Eur J Health Econ 2010, 12:311-317.
• [7]Tingstedt B, Andersson E, Flink A, Bolin K, Lindgren B, Andersson R: Pancreatic cancer, healthcare cost, and loss of productivity: a register-based approach. World J Surg 2011, 35:2298-2305.
• [8]Bradley CJ, Yabroff KR, Dahman B, Feuer EJ, Mariotto A, Brown ML: Productivity costs of cancer mortality in the United States: 2000-2020. J Natl Cancer Inst 2008, 100:1763-1770.
• [9]Yabroff KR, Mariotto AB, Feuer E, Brown ML: Projections of the costs associated with colorectal cancer care in the United States, 2000-2020. Health Econ 2008, 17:947-959.
• [10]Kim SG, Hahm MI, Choi KS, Seung NY, Shin HR, Park EC: The economic burden of cancer in Korea in 2002. Eur J Cancer Care (Engl) 2008, 17:136-144.
• [11]Tarricone R: Cost-of-illness analysis. What room in health economics? Health Policy 2006, 77:51-63.
• [12]Hanly P, O'Ceilleachair A, Skally M, O’Leary E, Staines A, Kapur K, Fitzpatrick P, Sharp L: Time costs associated with informal care for colorectal cancer: an investigation of the impact of alternative valuation methods. Appl Health Econ Health Policy 2013, 11:193-203.
• [13]World Health Organization: Mortality database. [http://www-dep.iarc.fr/WHOdb/WHOdb.htm webcite]
• [14]Central Statistics: Statbank - National Employment Survey. [http://www.cso.ie/px/pxeirestat/Database/eirestat/National%20Employment%20Survey/National%20Employment%20Survey_statbank.asp?SP=National Employment Survey&Planguage=0 webcite]
• [15]Central Statistics Office: Statbank- Quarterly National Household Survey. [http://www.cso.ie/px/pxeirestat/Database/eirestat/Quarterly%20National%20Household%20Survey%20Main%20Results/Quarterly%20National%20Household%20Survey%20Main%20Results_statbank.asp?SP=Quarterly National Household Survey Main Results&Planguage=0 webcite]
• [16]Bergin A, Conefrey T, Gerald JF, Kearney I: Recovery scenarios for Ireland. Economic and social research institute. Research Series 2009, 7. http://www.esri.ie/publications/latest_publications/view/index.xml?id=2774 webcite
• [17]The Economic and Social Research Institute (ESRI): Time-Use in Ireland 2005: Survey Report. [http://www.esri.ie/pdf/BKMNINT183_Prelims.pdf webcite]
• [18]O'Lorcain P, Walsh PM, Comber H: Cumulative cancer mortality risk and potential years of life lost to 64 years of age in Ireland, 1953-2002. Eur J Cancer Prev 2007, 16:167-177.
• [19]Health Information and Quality Authority: Guidelines for the economic evaluation of health technologies in Ireland. [http://www.hiqa.ie/publication/guidelines-economic-evaluation-health-technologies-ireland webcite]
• [20]Tinghog G, Carlsson P, Synnerstad I, Rosdahl I: Societal cost of skin cancer in Sweden in 2005. Acta Derm Venereol 2008, 88:467-473.
• [21]Tilson L, Sharp L, Usher C, Walsh C, Whyte S, O'Ceilleachair A, Stuart C, Mehigan B, John Kennedy M, Tappenden P, Chilcott J, Staines A, Comber H, Barry M: Cost of care for colorectal cancer in Ireland: a health care payer perspective. Eur J Health Econ 2012, 13:511-524.
• [22]Mehnert A: Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol 2011, 77:109-130.
• [23]National Cancer Registry Ireland: Cancer in Ireland 1994-2007. Annual Report of the National Cancer Registry. [http://www.ncri.ie/publications/annual-statistical-reports/cancer-ireland-1994-2007 webcite]
• [24]National Cancer Registry Ireland: Cancer in Ireland 1994-2005: a summary. Cork, Ireland: National Cancer Registry; 2007. http://ncri.ie/pubs/pubfiles/summary2007.pdf webcite
• [25]National Cancer Registry Ireland: Cancer in Ireland. Annual Report of the National Cancer Registry 2011. [http://www.ncri.ie/pubs/pubfiles/AnnualReport2011.pdf webcite]
• [26]Krol M, Papenburg J, Koopmanschap M, Brouwer W: Do productivity costs matter?: the impact of including productivity costs on the incremental costs of interventions targeted at depressive disorders. Pharmacoeconomics 2011, 29:601-619.
• [27]Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB: Recommendations of the panel on cost-effectiveness in health and medicine. JAMA 1996, 276:1253-1258.
• [28]Hanly P, Timmons A, Walsh PM, Sharp L: Breast and prostate cancer productivity costs: a comparison of the human capital approach and the friction cost approach. Value Health 2012, 15:429-436.
• [29]Hanly P, Walsh PM, O'Ceilleachair A, Skally M, Staines A, Kapur K, Fitzpatrick P, Sharp L: Work-related productivity losses in an era of ageing populations: the case of colorectal cancer. J Occup Environ Med 2013, 55:128-134.