Indirect Costs Associated with Human Epidermal Growth Factor Receptor Positive (HER2+) Metastatic Breast Cancer

Abstract

Objective To estimate the indirect costs associated with a diagnosis of human epidermal growth factor receptor positive (HER2+) metastatic breast cancer (mBC) compared to non-cancer controls. Methods We performed a matched retrospective cohort analysis using the IBM MarketScanⓇ Databases from 2008 – 2018, comparing the differences in hours missed due to absenteeism and days missed due to short-term disability (STD) among adult female patients with HER2+ mBC aged 18-64 compared to non-cancer controls during the first 12 months after mBC diagnosis. We estimated multivariable linear regression models to estimate the indirect costs associated with the diagnosis. Results A total of 68 subjects with HER2+ mBC and 198 controls with absenteeism data, and 509 HER2+ mBC subjects and 1522 controls eligible for STD were included in the study. Among employees with absenteeism benefits, patients with HER2+ mBC missed an estimated 372 (95% CI: 240 to 505) more hours during the 12 months after diagnosis compared to controls. This resulted in estimated annual employee absenteeism productivity losses of $10,424 for patients with HER2+ mBC versus $3,501 for controls (difference of $6,923 [95% CI: 779 to 1251]). Among employees with STD eligibility, the estimated the mean missed days among those with HER2+ mBC was 27 (95% CI: 22 to 31) days higher than those without cancer. This resulted in an incremental estimated $3,942 (95% CI: 3,250 to 4,634) annual productivity loss due to STD for HER2+ mBC patients. Conclusions Workplace productivity losses are associated with patients who have HER2+ mBC compared to those without the diagnosis. These indirect costs should be considered when calculating the burden of illness of HER2+ mBC.