Objective Real-World Caregiver Costs and Lost Time for Absences and Family Medical Leaves in the United States for Employees Whose Spouses Have Dementia and/or Alzheimer’s Disease and Patient Direct Costs
Author(s)
Richard A. Brook, MBA, MS1, Stephen A Schramm, MA2, Alek A Drnach, MS2, Ian A. Beren, BS3, Eric Michael Rosenberg, MA, MA4.
1President (BH-WW) / SVP (NPRT), Better Health Worldwide / NPRT, Newfoundland, NJ, USA, 2Integrated Analytics, Workpartners LLC, Pittsburgh, PA, USA, 3Integrated Analytics, WorkPartners, LLC, Denver, CO, USA, 4Integrated Analytics, WorkPartners, LLC, Pittsburgh, PA, USA.
1President (BH-WW) / SVP (NPRT), Better Health Worldwide / NPRT, Newfoundland, NJ, USA, 2Integrated Analytics, Workpartners LLC, Pittsburgh, PA, USA, 3Integrated Analytics, WorkPartners, LLC, Denver, CO, USA, 4Integrated Analytics, WorkPartners, LLC, Pittsburgh, PA, USA.
OBJECTIVES: About 11million unpaid caregivers support 7million individuals with Alzheimer’s disease(AD), contributing 8.4billion hours of care valued at $350billion. With new AD-treatments emerging, we assessed baseline absence-time and direct-costs for patients and their employee caregivers.
METHODS: Retrospective analysis of Workpartners Research Reference Database(2018—2022) of US self-insured employees and their families. Pairs of employee caregivers and patients with diagnoses of AD, dementia only (DEM),or BOTH (AD+Dem) were identified. All pairs had >1year of continuous data following initial patient-Dx. Outcomes included: employee caregiver Discretionary Incidental Time-off (DITO) and Family Medical Leaves (FML) absence days and claims, direct costs (MED$ and Rx$) for the employee caregivers and patients.
RESULTS: 2851 patient-caregiver pairs met inclusion criteria (AD=23.8%, DEM=79.2%, 10.2%=BOTH). From 2018—2022 there were increases in dependent diagnoses (AD=1.9x,DEM+BOTH>2x) while patient-age at Dx decreased. Caregiver FML absence-days ranged from 20—49days for AD,10—20days for DEM,11.4—27.7days for BOTH. FML absence-days peaked in 2020 (all groups). Caregivers average DITO-days increased over the time period by ~3.0days (BOTH+DEM) and decreased 0.9days (AD). Majority of MED$ were for patients (average AD=70.9%,DEM=74.6%,BOTH=72.2%). Patient mean MED$ decreased for all groups (AD increased in 2020),caregiver MED$ were flat prior to a post-2020 AD increase. RX$ were highest for patients with: DEM=64.1%,BOTH=60.2%,AD=41.0%. Patients’ RX$ increased slightly over the period peaks in 2020 (DEM+BOTH) and 2021(AD). Caregivers’ RX$ increased over the entire time frame (DEM+BOTH) and AD caregivers’ Rx costs increased all years except for a 54% decrease from the 2019 high to a low in 2020.
CONCLUSIONS: As the diagnosis age for Alzheimer's disease and dementia continues to decrease, more employees will assume caregiving roles and may require time-off to help manage their affected partners. Understanding the baseline costs and lost time impact of these conditions on their covered (patient and caregiver) lives allows employers to determine the value of coverage for emerging therapies.
METHODS: Retrospective analysis of Workpartners Research Reference Database(2018—2022) of US self-insured employees and their families. Pairs of employee caregivers and patients with diagnoses of AD, dementia only (DEM),or BOTH (AD+Dem) were identified. All pairs had >1year of continuous data following initial patient-Dx. Outcomes included: employee caregiver Discretionary Incidental Time-off (DITO) and Family Medical Leaves (FML) absence days and claims, direct costs (MED$ and Rx$) for the employee caregivers and patients.
RESULTS: 2851 patient-caregiver pairs met inclusion criteria (AD=23.8%, DEM=79.2%, 10.2%=BOTH). From 2018—2022 there were increases in dependent diagnoses (AD=1.9x,DEM+BOTH>2x) while patient-age at Dx decreased. Caregiver FML absence-days ranged from 20—49days for AD,10—20days for DEM,11.4—27.7days for BOTH. FML absence-days peaked in 2020 (all groups). Caregivers average DITO-days increased over the time period by ~3.0days (BOTH+DEM) and decreased 0.9days (AD). Majority of MED$ were for patients (average AD=70.9%,DEM=74.6%,BOTH=72.2%). Patient mean MED$ decreased for all groups (AD increased in 2020),caregiver MED$ were flat prior to a post-2020 AD increase. RX$ were highest for patients with: DEM=64.1%,BOTH=60.2%,AD=41.0%. Patients’ RX$ increased slightly over the period peaks in 2020 (DEM+BOTH) and 2021(AD). Caregivers’ RX$ increased over the entire time frame (DEM+BOTH) and AD caregivers’ Rx costs increased all years except for a 54% decrease from the 2019 high to a low in 2020.
CONCLUSIONS: As the diagnosis age for Alzheimer's disease and dementia continues to decrease, more employees will assume caregiving roles and may require time-off to help manage their affected partners. Understanding the baseline costs and lost time impact of these conditions on their covered (patient and caregiver) lives allows employers to determine the value of coverage for emerging therapies.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH172
Topic
Economic Evaluation, Epidemiology & Public Health, Real World Data & Information Systems
Disease
Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas