- 作者：Paul Hanly ; BA ; MA ; PhD ; p.hanly@ncri.ie ; Aileen Timmons ; BSc ; MSc ; PhD ; Paul M. Walsh ; MSc ; PhD ; Linda Sharp ; BSc ; MSc ; PhD
- 关键词：burden of illness ; cancer ; friction cost approach ; human capital approach ; productivity costs
- 刊名：Value in Health
- 出版年：2012
- 期刊代码：pca366_10983015
- 类别：med
- 出版时间：May, 2012
- 卷：15
- 期：3
- 页码：429-436
- 文件大小：406 K
Objectives
Productivity costs constitute a substantial proportion of the total societal costs associated with cancer. We compared the results of applying two different analytical methods鈥攖he traditional human capital approach (HCA) and the emerging friction cost approach (FCA)鈥攖o estimate breast and prostate cancer productivity costs in Ireland in 2008.Methods
Data from a survey of breast and prostate cancer patients were combined with population-level survival estimates and a national wage data set to calculate costs of temporary disability (cancer-related work absence), permanent disability (workforce departure, reduced working hours), and premature mortality.
Results
For breast cancer, productivity costs per person using the HCA were 鈧?93,425 and those per person using the FCA were 鈧?,103; for prostate cancer, the comparable estimates were 鈧?09,154 and 鈧?,205, respectively. The HCA generated higher costs for younger patients (breast cancer) because of greater lifetime earning potential. In contrast, the FCA resulted in higher productivity costs for older male patients (prostate cancer) commensurate with higher earning capacity over a shorter time period. Reduced working hours postcancer was a key driver of total HCA productivity costs. HCA costs were sensitive to assumptions about discount and growth rates. FCA costs were sensitive to assumptions about the friction period.
Conclusions
The magnitude of the estimates obtained in this study illustrates the importance of including productivity costs when considering the economic impact of illness. Vastly different results emerge from the application of the HCA and the FCA, and this finding emphasizes the importance of choosing the study perspective carefully and being explicit about assumptions that underpin the methods.