Indirect Costs and Workplace Productivity Loss Associated with Non-Hodgkin's Lymphoma
Yu, Justin Sammy
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Background Non-Hodgkin’s lymphoma (NHL) is the 7th most common type of cancer in the United States (U.S.) based on incidence.1 Despite this, there is an absence of published literature on the indirect costs and workplace productivity loss associated with NHL. Objective The objective of this study was to examine the indirect costs and workplace productivity loss (defined as an aggregate measure of absenteeism, short-term disability (STD), and long-term disability (LTD) days) associated with NHL from a societal perspective in the commercially insured U.S. population. Methods The MarketScan® Commercial Claims and Encounters (CCAE) and Health and Productivity Management (HPM) Databases (2007-2013) were used for this study. The NHL cohort consisted of patients aged 18-64 years on the date of first diagnosis of NHL (index date), continuously enrolled for ≥6 months before and ≥12 months after the index date, with no diagnoses of other cancers prior to the index date, with non-missing data on absenteeism, STD, and LTD for ≥12 months after the index date, with ≥2 additional diagnoses of NHL on different days in the 60-day post-index period, and with no diagnoses of Hodgkin’s lymphoma in the 12-month post-index period. Afterwards, controls without NHL and satisfying all except the last two inclusion/exclusion criteria were matched 3:1 based on index year, 5-year age group, and region. Multiple regression analyses adjusting for covariates were then used to estimate the differences in mean days of workplace productivity loss and associated indirect costs for NHL patients versus controls. Results In comparison to controls, NHL patients incurred significantly more workplace productivity loss (31.99 days; 95% CI: 25.24 days, 38.73 days; p < 0.001) in the 12-month post-index period when adjusting for covariates. Consequently, NHL patients incurred significantly more indirect costs ($6,302.34; 95% CI: $4,973.40, $7,631.28; p < 0.001) compared to controls when adjusting for the same covariates. Conclusions NHL can have a significant impact on workplace productivity loss, which translates to higher indirect costs to society. As the first study to address major gaps in evidence regarding NHL, these findings contribute substantially to understanding the disease’s burden of illness.