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Real world evidence

Measure the impacts of patient productivity loss and caregiver burden with real-world data

Published April 3, 2024 | 5 min read
Academics Real world evidence Life sciences Data quality Real-world data Longitudinal data

Eleanor Gebauer

Director, Real-World Data Research & Analytics Services, MarketScan by Merative

When patients are struck with illness, their quality of life and well-being are of the utmost concern, but it can be hard to ignore the additional stressors piling on. Not only are they hit with medical costs, but patients and their caregivers also experience productivity loss due to taking sick time, medical leave, or losing their jobs. Individuals caring for their loved ones may also overlook their own physical and mental health, resulting in caregiver burden.

Productivity loss is a critical factor in assessing disease burden, cost effectiveness of treatments and interventions, workplace wellness, and disease management programs, but it can be hard to measure. To accurately quantify the indirect costs and impacts associated with patient and caregiver health, access to care, and treatment options, researchers need access to robust productivity data. Where do they find that data and how can it be leveraged?

Data sources for productivity loss

When measuring productivity loss, prospective data collection, surveys, and administrative claims are the main data sources.1 Despite being widely used, collecting survey and prospective data comes with inherent limitations, requires time and money, and is often unable to capture patients’ healthcare experience beyond the clinical variables included in data collection. This area of complexity is where linking real-world data (RWD) sources shines, such as administrative claims databases with productivity loss data.

Administrative claims offer unique insights for healthcare research and help paint a more complete picture of a patient’s healthcare experience. By linking administrative claims data with productivity data, such as the MarketScan® Health and Productivity Management (HPM) Database, one can uncover the direct medical costs and indirect costs due to productivity loss for patients and their caregivers after diagnosis or undergoing treatments.

Publications with MarketScan

The linked MarketScan Commercial-HPM Database has been widely used to study illness-related productivity loss and has earned the trust of healthcare researchers worldwide. The Commercial Database contains claims data for 228 million enrollees, encompassing employees, spouses, and dependents covered by employer-sponsored private health plans. The HPM Database contains integrated data regarding workplace absence, short-term disability (STD), long-term disability (LTD), and workers’ compensation for 17.6 million employees between 1997 and 2021. Identified by enrollee ID or family ID in the MarketScan Database, one can identify patients and their family members and ascertain patients’ and caregivers’ healthcare experience and the associated productivity losses.

Publication 1: Costs Associated with Productivity Loss Among U.S. Patients Newly Diagnosed with Multiple Myeloma Receiving Oral Versus Injectable Chemotherapy2

Injectable chemotherapy requires traveling to the clinic and may result in injection site infections and other complications, whereas oral medication presents a safer and more convenient alternative. This study confirmed that route of administration was a significant predictor of productivity loss, and injectable chemotherapy use resulted in $3,886 greater lost wages than use of oral chemotherapy, within 1 year following multiple myeloma diagnosis.

Publication 2: Work Loss and Direct and Indirect Costs Associated with Parkinson's Disease3

The average onset of Parkinson’s disease (PD) is 60 years old, when patients and their spouses are often still working – making indirect cost estimates an important assessment of PD burden. However, such data are rarely available and productivity loss associated with PD caregiver burden is largely omitted from economic models, despite its importance. Leveraging 15 years of MarketScan data, this study reported steady increases in direct healthcare costs and indirect costs associated with STD for PD patients during three years before and after PD was diagnosed. Caregivers’ STD days increased dramatically in the 2nd and 3rd year after PD diagnosis, possibly reflecting the toll taken on caregivers’ health and productivity as PD progresses.

Data from the quoted studies and others illustrate how illness can impair patients’ and their caregivers’ work productivity and confer significant societal costs – in addition to the direct medical costs. Depending on the nature of the disease, the downstream impact on productivity loss may have ebbs and flows and last for years; thus, a long observation period is often required to understand the totality of the impact. Data sources with strong longitudinality are pivotal in addressing these research objectives. In the PD study described above, the same patients and caregivers were followed for six years, allowing “a consistent denominator population throughout the entire six-year period in order to avoid spurious trends due to non-random attrition.”3

Through linking productivity data to a complete and closed system of medical and pharmacy claims and enrollment records, the MarketScan HPM database is the one-stop shop to analyze patient characteristics, treatments, direct healthcare costs, and the indirect costs associated with productivity loss over time from an employed, privately insured population.

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References:

  1. Rojanasarot S, Bhattacharyya SK, Edwards N. Productivity loss and productivity loss costs to United States employers due to priority conditions: a systematic review. J Med Econ. 2023 Jan-Dec;26(1):262-270.
  2. Merola D, Yong C, Noga SJ, Shermock KM. Costs Associated with Productivity Loss Among U.S. Patients Newly Diagnosed with Multiple Myeloma Receiving Oral Versus Injectable Chemotherapy. J Manag Care Spec Pharm. 2018 Oct;24(10):1019-1026.
  3. Jerry M, Arcona S, McMorrow D, Schwartz H, Princic N, Sasane R. Work Loss and Direct and Indirect Costs Associated with Parkinson's Disease. Clinicoecon Outcomes Res. 2023 Apr 27;15:309-319.

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