Work productivity among patients with metastatic breast cancer in the United States

ABSTRACT

Objective

To characterize workplace productivity measures in patients with metastatic breast cancer (mBC) using line of therapy (LOT) and first line (1 L) regimen.

Methods

A retrospective cohort study was conducted using IBM’s MarketScan Commercial Claims and Encounters (CCAE) and Health and Productivity Management (HPM) databases. The cohort included patients diagnosed with mBC who initiated 1 L treatment between 2/3/2015 and 6/30/2018. Productivity was measured using days absent from work and short- and long-term disability (STD, LTD) claims by LOT and 1 L regimen (any cyclin-dependent kinase 4/6 inhibitor [CDK4/6i], endocrine monotherapy, chemotherapy only, or other anti-cancer therapy [OACT]). LOT was defined using regimen-based progression.

Results

Overall, 548 patients were included; 148, 129, 145, and 126 received endocrine monotherapy, CDK4/6i, chemotherapy only, and OACT, respectively. The rate of LTD increased significantly by 3.1 and 2.6 times from 1 L to second line (2 L) and from 2 L to subsequent lines, respectively. Patients receiving 1 L chemotherapy had 2.4- and 2.7-times odds of using STD and LTD compared to patients receiving 1 L CDK4/6i.

Conclusions

Regimen-based disease progression is associated with increased use of STD and LTD. Patients with a 1 L regimen of chemotherapy have significantly higher odds of using STD or LTD than patients using 1 L CDK4/6i.

KEYWORDS:

• Cyclin-dependent kinase 4/6 inhibitors
• disease progression
• line of therapy
• metastatic breast cancer
• regimen-based disease progression
• work productivity

Acknowledgments

This study was sponsored by Pfizer Inc. The sponsor was involved in the design of the study; the review and approval of the manuscript; and the decision to submit the manuscript for publication. Sneha Durgapal, Sharon Kautz, Steve Sison, and Christina Cool are employees of Precision Value and Health, which was a paid consultant to Pfizer in connection with the development of this manuscript. Kent Hanson is an employee of the University of Illinois at Chicago, which was a paid consultant to Pfizer in connection with the development of this manuscript. We thank Kenneth Ching and Jeff Sullivan for their methodological insights and guidance on the statistical analyses.

Author contributions

All authors were involved in the conception and design of the study, analysis, or interpretation of the data, and drafting of the paper or revising it critically for intellectual content. All authors approved of the final version for publication and are accountable for all aspects of the work.

Declaration of interest

S Durgapal is an employee of Precision Value and Health and a paid consultant to Pfizer in connection with the development of this manuscript. K Hanson is funded by the University of Illinois at Chicago/Pfizer Health Economics and Outcomes Research Fellowship (2020–2022). S Kurosky is an employee and stockholder in Pfizer Inc. S Kautz is an employee of Precision Value and Health and a paid consultant to Pfizer in connection with the development of this manuscript. S Sison is an employee of Precision Value and Health and a paid consultant to Pfizer in connection with the development of this manuscript. C Cool is an employee of Precision Value and Health and paid consultant to Pfizer in connection with the development of this manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Prior presentation

This is an original work and is not under consideration by any other journal. The data were presented in part at the Professional Society for Health Economics and Outcomes Research – Europe (ISPOR-EU) Virtual Congress, 30 November–3 December 2021: Work Productivity in Patients with Metastatic Breast Cancer: A Retrospective Analysis of Claims Data in the US POSA396

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2022.2108409

Additional information

Funding

This study was sponsored by Pfizer.