WORK PRODUCTIVITY IN HER2 POSITIVE BREAST CANCER- A COMPARISON OF PATIENTS ACROSS STAGES OF EARLY AND METASTATIC DISEASE.
Author(s)
Verrill M1, Schmid P2, Retzler J3, Smith AB3, Bottomley CJ4, Dando S5, Tran I5, Leslie I5, Wardley A6
1Northern Centre for Cancer Care, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne, UK, 2Barts Cancer Institute, Queen Mary University of London, London, UK, 3York Health Economics Consortium Ltd, York, UK, 4pH Associates (an Open Health company), Marlow, UK, 5Roche Products Limited, Welwyn Garden City, UK, 6The Christie NHS Foundation Trust, Manchester, UK
OBJECTIVES: While the clinical impact of HER2+ breast cancer (HER2+BC) is well described, data on the societal impact are lacking. This study compared work productivity in three HER2+ patient groups: early (E)BC during adjuvant treatment, EBC post-treatment, and metastatic (M)BC. METHODS: A cross-sectional, observational study of 299 consenting female patients recruited from 14 secondary care centres. Group1 (n=89): receiving targeted HER2 therapy±chemotherapy for EBC; Group2 (n=108): in follow-up post-targeted treatment for EBC; Group3 (n=102): MBC on treatment. Patients completed questionnaires including the Work Productivity and Activity Impairment (WPAI) measure and EQ-5D-5L; clinical staff collected patient and disease characteristics from medical records. Associations and inter-group differences were assessed using correlational analysis and univariate analysis of variance (ANOVA). [NCT03099200]. RESULTS: Fewer Group3 patients were employed (n=28) compared to Group1 (n=45) and Group2 (n=55) (p<0.003), with more reporting an inability to work (Group3: n=27, Group1: n=7, Group2: n=5) (p<0.003). Of employed patients, Group2 reported lower mean (SD) levels of work absenteeism (9% [24%]) and overall work impairment (26% [31%]), compared to Group1 (38% [44%]; p<0.001 and 49% [40%]; p=0.015, respectively), and marginally lower mean (SD) levels of absenteeism than Group3 (31% [44%]; p=0.068). Across all patients (including unemployed), mean (SD) activity impairment in Group1 (34% [28%]) and Group2 (28% [26%]) was lower than in Group3 (48% [31%]; p<0.005). Across groups, higher work and activity impairments were associated with lower EQ-5D-5L health utility: r=-.3950; p<0.001, and r=-0.6670; p<0.001, respectively. CONCLUSIONS: The relatively low levels of absenteeism and work impairment reported by employed patients suggest that those who were able to work remained productive. However, a higher proportion of MBC patients were unable to work, and reported significantly higher levels of overall activity impairment compared to those with EBC. Impairment was related to health utility, reflecting the overall impact of advanced disease.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCN234
Topic
Economic Evaluation, Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes, Work & Home Productivity - Indirect Costs
Disease
Oncology