Applied Health Economics and Health Policy

, Volume 13, Issue 4, pp 359–367 | Cite as

Productivity Losses Associated with Head and Neck Cancer Using the Human Capital and Friction Cost Approaches

  • Alison M. PearceEmail author
  • Paul Hanly
  • Aileen Timmons
  • Paul M. Walsh
  • Ciaran O’Neill
  • Eleanor O’Sullivan
  • Rachael Gooberman-Hill
  • Audrey Alforque Thomas
  • Pamela Gallagher
  • Linda Sharp
Original Research Article



Previous studies suggest that productivity losses associated with head and neck cancer (HNC) are higher than in other cancers. These studies have only assessed a single aspect of productivity loss, such as temporary absenteeism or premature mortality, and have only used the Human Capital Approach (HCA). The Friction Cost Approach (FCA) is increasingly recommended, although has not previously been used to assess lost production from HNC. The aim of this study was to estimate the lost productivity associated with HNC due to different types of absenteeism and premature mortality, using both the HCA and FCA.


Survey data on employment status were collected from 251 HNC survivors in Ireland and combined with population-level survival estimates and national wage data. The cost of temporary and permanent time off work, reduced working hours and premature mortality using both the HCA and FCA were calculated.


Estimated total productivity losses per employed person of working age were EUR253,800 using HCA and EUR6800 using FCA. The main driver of HCA costs was premature mortality (38 % of total) while for FCA it was temporary time off (73 % of total).


The productivity losses associated with head and neck cancer are substantial, and return to work assistance could form an important part of rehabilitation. Use of both the HCA and FCA approaches allowed different drivers of productivity losses to be identified, due to the different assumptions of the two methods. For future estimates of productivity losses, the use of both approaches may be pragmatic.


Neck Cancer Productivity Loss Premature Mortality Wage Growth Human Capital Approach 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank the study participants and the consultants and their teams who assisted with reviewing subjects’ details. We are grateful to the following: Michal Molcho for participation in the ICE Steering Committee; Phyllis Butow for participation in the SuN Steering Committee; and National Cancer Registry Ireland staff involved in collection and processing of cancer registrations.

Financial and other support

This work was funded by a Health Research Board (HRB) Interdisciplinary Capacity Enhancement (ICE) Award, which funds post-doctoral fellowships for Alison Pearce, Audrey Alforque Thomas and Aileen Timmons (ICE/2012/9). The SuN study survey development and data collection was funded by an HRB project grant (HRA/2009/262).

Conflicts of interest

Alison Pearce, Paul Hanly, Aileen Timmons, Paul Walsh, Ciaran O’Neill, Eleanor O’Sullivan, Rachael Gooberman-Hill, Audrey Thomas, Pamela Gallagher and Linda Sharp report no conflicts of interest.

Author contributions

All authors reviewed and provided expert input to the analysis protocol, interpretation of results and drafts of the manuscript. In addition, AP cleaned the data, conducted the analysis and drafted the manuscript. PH suggested and advised on the methodology and assisted with the analysis and interpretation. AT conducted the survey of head and neck cancer patients. PW analysed the National Cancer Registry data. LS, AT, RGH, CON and PG obtained funding. LS initiated the project, she was Principal Investigator of the SuN survey study, and is the guarantor for the overall content.

Supplementary material

40258_2015_155_MOESM1_ESM.docx (20 kb)
Supplementary material 1 (DOCX 20 kb)


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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Alison M. Pearce
    • 1
    Email author
  • Paul Hanly
    • 2
  • Aileen Timmons
    • 1
  • Paul M. Walsh
    • 1
  • Ciaran O’Neill
    • 3
  • Eleanor O’Sullivan
    • 4
  • Rachael Gooberman-Hill
    • 5
  • Audrey Alforque Thomas
    • 3
  • Pamela Gallagher
    • 6
  • Linda Sharp
    • 1
  1. 1.National Cancer Registry IrelandCorkIreland
  2. 2.National College of IrelandDublinIreland
  3. 3.National University of Ireland GalwayGalwayIreland
  4. 4.Cork University Dental School and HospitalCorkIreland
  5. 5.University of BristolBristolIreland
  6. 6.Dublin City UniversityDublinIreland

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