title: Breast and prostate cancer productivity costs: a comparison of the human capital approach and the friction cost approach.
abstract: OBJECTIVE
  Productivity costs constitute a substantial proportion of the total societal costs associated with cancer. We compared the results of applying two different analytical methods--the traditional human capital approach (HCA) and the emerging friction cost approach (FCA)--to estimate breast and prostate cancer productivity costs in Ireland in 2008.
  
  
  METHODS
  Data from a survey of breast and prostate cancer patients were combined with population-level survival estimates and a national wage data set to calculate costs of temporary disability (cancer-related work absence), permanent disability (workforce departure, reduced working hours), and premature mortality.
  
  
  RESULTS
  For breast cancer, productivity costs per person using the HCA were € 193,425 and those per person using the FCA were € 8,103; for prostate cancer, the comparable estimates were € 109,154 and € 8,205, respectively. The HCA generated higher costs for younger patients (breast cancer) because of greater lifetime earning potential. In contrast, the FCA resulted in higher productivity costs for older male patients (prostate cancer) commensurate with higher earning capacity over a shorter time period. Reduced working hours postcancer was a key driver of total HCA productivity costs. HCA costs were sensitive to assumptions about discount and growth rates. FCA costs were sensitive to assumptions about the friction period.
  
  
  CONCLUSIONS
  The magnitude of the estimates obtained in this study illustrates the importance of including productivity costs when considering the economic impact of illness. Vastly different results emerge from the application of the HCA and the FCA, and this finding emphasizes the importance of choosing the study perspective carefully and being explicit about assumptions that underpin the methods.
authors.affiliation: National Cancer Registry Ireland, Cork, Ireland. p.hanly@ncri.ie
authors.forename: Paul
authors.initials: P
authors.lastname: Hanly
authors.forename: Aileen
authors.initials: A
authors.lastname: Timmons
authors.forename: Paul M
authors.initials: PM
authors.lastname: Walsh
authors.forename: Linda
authors.initials: L
authors.lastname: Sharp
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000191:economics*; D017281:Cost of Illness; D003365:Costs and Cost Analysis / Q000379:methods; D003625:Data Collection; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000191:economics*; D018582:Sick Leave / Q000191:economics*; D055815:Young Adult