Skip to main content
SpringerLink
Log in

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

  • Original Research Article
  • Published:
Applied Health Economics and Health Policy Aims and scope Submit manuscript

Abstract

Objectives

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.

Methods

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.

Results

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).

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. National Cancer Registry Ireland. Cancers of the head and neck. Cancer trends No. 10. National Cancer Registry Ireland: Cork; 2011.

    Google Scholar 

  2. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JWW, Comber H, et al. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. Eur J Cancer. 2013;49:1374–403.

    Article  CAS  PubMed  Google Scholar 

  3. Adelstein DJ, Ridge JA, Gillison ML, Chaturvedi AK, D’Souza G, Gravitt PE, et al. Head and neck squamous cell cancer and the human papillomavirus: summary of a National Cancer Institute State of the Science Meeting, November 9–10, 2008, Washington, DC. Head Neck. 2009;31(11):1393–422.

    Article  PubMed  Google Scholar 

  4. Coughlan D, Frick KD. Economic impact of human papillomavirus-associated head and neck cancers in the United States. Otolaryngol Clin North Am. 2012;45:899–917.

    Article  PubMed  Google Scholar 

  5. Buckwalter AE, Karnell LH, Smith RB, Christensen AJ, Funk GF. Patient-reported factors associated with discontinuing employment following head and neck cancer treatment. Arch Otolaryngol Head Neck Surg. 2007;133(May):464–70.

    Article  PubMed  Google Scholar 

  6. Verdonck-de Leeuw IM, van Bleek WJ, Leemans CR, de Bree R. Employment and return to work in head and neck cancer survivors. Oral Oncology. 2010;46:56–60.

  7. Chang KP, Lai CS, Hsieh TY, Wu YC, Chang CH. Two-year quality of life after free flap reconstruction in tumor-site discrepancy among Taiwanese with moderately advanced oral squamous cell carcinoma. World J Surg Oncol. 2012;10:145.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Pearce AM, Timmons A, O’Sullivan E, Gallagher P, Gooberman-Hill R, Thomas AA, et al. Long-term workforce participation patterns following head and neck cancer. J Cancer Surviv. 2014 [Epub ahead of print].

  9. Syse A, Tretli S, Kravdal O. Cancer’s impact on employment and earnings—a population-based study from Norway. J Cancer Surviv. 2008;2:149–58.

    Article  PubMed  Google Scholar 

  10. Ramirez MJF, Ferriol EE, Domenech FG, Llatas MC, Suarez-Varela MM, Martinez RL. Psychosocial adjustment in patients surgically treated for laryngeal cancer. Otolaryngol Head Neck Surg. 2003;129(1):92–7.

  11. Weisbrod B. Economics of public health. Philadelphia: University of Pannsylvania Press; 1961.

    Google Scholar 

  12. Cooper BS, Rice DP. The economic cost of illness revisited. Soc Secur Bull. 1976;39:21–36.

    CAS  PubMed  Google Scholar 

  13. Johannesson M, Karlsson G. The friction cost method: a comment. J Health Econ. 1997;16:249–55.

    Article  CAS  PubMed  Google Scholar 

  14. Koopmanschap MA, Rutten FF, Van Ineveld BM, van Roijen L. The friction cost method for measuring indirect costs of disease. J Health Econ. 1995;14:171–89.

    Article  CAS  PubMed  Google Scholar 

  15. Knies S, Severens JL, Ament AJHA, Evers SMAA. The transferability of valuing lost productivity across jurisdictions. Differences between national pharmacoeconomic guidelines. Value Health. 2010;13(5):519–27.

    Article  PubMed  Google Scholar 

  16. Ekwueme DU, Chesson HW, Zhang KB, Balamurugan A. Years of potential life lost and productivity costs because of cancer mortality and for specific cancer sites where Human Papillomavirus may be a risk factor for carcinogenesis—United States, 2003. Cancer. 2008;113(10 suppl):2936–45.

    Article  PubMed  Google Scholar 

  17. 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(24):1763–70.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Borget I, Abramowitz L, Mathevet P. Economic burden of HPV-related cancers in France. Vaccine. 2011;29(32):5245–9.

  19. Citizens Information Board. Sick leave and sick pay. 2013. http://www.citizensinformation.ie/en/employment/employment_rights_and_conditions/leave_and_holidays/sick_leave.html. Accessed 19 Nov 2013.

  20. Office for National Statistics. Standard occupational classification 2010. http://www.ons.gov.uk/ons/guide-method/classifications/current-standard-classifications/soc2010/index.html. Accessed 19 Nov 2013.

  21. Central Statistics Office. National employment survey. NSA06: mean and median hourly earnings by employment status, sex, occupation, year and statistic. 2013. http://www.cso.ie/px/pxeirestat/Statire/SelectVarVal/Define.asp?maintable=NSA06&PLanguage=0. Accessed 19 Nov 2013.

  22. The Economic and Social Research Institute. Irish economy. 2012. http://www.esri.ie/irish_economy/. Accessed 10 July 2013.

  23. Health Information and Quality Authority. Guidelines for the economic evaluation of health technologies in Ireland. In: Health Information and Quality Authority, editor. Health Information and Quality Authority; 2010.

  24. Hanly P, Koopmanschap MA, Sharp L. The friction cost approach in a changing macroeconomic environment: the case of colorectal cancer productivity costs. TBC. Draft. [under review].

  25. 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(3):429–36.

    Article  PubMed  Google Scholar 

  26. Central Statistics Office. Irish life tables No. 15, 2005–2007. Dublin: Central Statistics Office; 2009.

  27. Hanly P, Walsh PM, Ó Céilleachair A, Skally M, Staines A, Kapur K, et al. Work-related productivity losses in an era of ageing populations: the case of colorectal cancer. J Occup Environ Med. 2013;55(2):128–34.

    Article  PubMed  Google Scholar 

  28. Oliva J, Lobo F, Lopez-Bastida J, Zozaya N, Romay R. Indirect costs of cervical and breast cancers in Spain. Eur J Health Econ. 2005;6:30–313.

    Article  Google Scholar 

  29. Penner JL. Psychosocial care of patients with head and neck cancer. Semin Oncol Nurs. 2009;25(3):231–41.

    Article  PubMed  Google Scholar 

  30. Lensberg BR, Drummond MF, Danchenko N, Despiegel N, Francois C. Challenges in measuring and valuing productivity costs, and their relevance in mood disorders. Clinicoecon Outcomes Res. 2013;5:565–73.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Williams A. Cost-effectiveness analysis: is it ethical? J Med Ethics. 1992;18:7–11.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  32. Tranmer JE, Guerriere DN, Ungar WJ, Coyte PC. Valuing patient and caregiver time: a review of the literature. Pharmacoeconomics. 2005;23(5):449–59.

    Article  PubMed  Google Scholar 

  33. Liljas B. How to calculate indirect costs in economic evaluations. Pharmacoeconomics. 1998;13(1 (Part 1)):1–7.

Download references

Acknowledgments

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.

Author information

Authors and Affiliations

  1. National Cancer Registry Ireland, Cork, Ireland

    Alison M. Pearce, Aileen Timmons, Paul M. Walsh & Linda Sharp

  2. National College of Ireland, Dublin, Ireland

    Paul Hanly

  3. National University of Ireland Galway, Galway, Ireland

    Ciaran O’Neill & Audrey Alforque Thomas

  4. Cork University Dental School and Hospital, Cork, Ireland

    Eleanor O’Sullivan

  5. University of Bristol, Bristol, Ireland

    Rachael Gooberman-Hill

  6. Dublin City University, Dublin, Ireland

    Pamela Gallagher

Authors
  1. Alison M. Pearce
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul Hanly
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aileen Timmons
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paul M. Walsh
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ciaran O’Neill
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eleanor O’Sullivan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Rachael Gooberman-Hill
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Audrey Alforque Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Pamela Gallagher
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Linda Sharp
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alison M. Pearce.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 20 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pearce, A.M., Hanly, P., Timmons, A. et al. Productivity Losses Associated with Head and Neck Cancer Using the Human Capital and Friction Cost Approaches. Appl Health Econ Health Policy 13, 359–367 (2015). https://doi.org/10.1007/s40258-015-0155-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40258-015-0155-8

Keywords

Search

Navigation