Estimating the indirect costs associated with adenocarcinoma or squamous cell carcinoma of the oesophagus in Switzerland: evidence from a cross-sectional survey.

Abstract

Objectives: Our study investigated the impact of oesophageal cancer and its treatments on work productivity, leisure time, household chores and informal care in Switzerland. We assessed indirect costs for patients treated at different stages of adenocarcinoma or squamous cell carcinoma of the oesophagus.

Design and setting: A retrospective, non-interventional survey was conducted among patients diagnosed with early or advanced oesophageal cancer in Switzerland. Between January 2023 and October 2023, 126 patients participated from seven clinical centres across German, French and Italian language regions.

Outcome measure: Self-reported lost time over a 4-week period, which was monetised to estimate indirect costs using respondents' approximate earnings derived from national statistics.

Results: Of the 126 patients, 24 (19.0%) were disease-free at the time of the study, while 15.1% of patients were in stage I, 13.5% in stage II, 27.0% in stage III and 25.4% in stage IV. Most patients, across age groups and disease stages, reported no impact on their leisure time (62.2%), household chores (70.3%) or informal care needs (78.4%) in the last 4 weeks. For those affected, the mean loss of time was 9.5 hours per week for leisure (n=28) and 13.3 hours for household chores (n=21). Additionally, patients received an average of 11.8 hours of informal care per week (n=16). Among the patients who were employed at the beginning of the 4-week recall period (n=25), 57.1% reduced the degree of employment and/or missed work due to the disease and its treatments during that time, while 46.7% experienced presentism (decreased productivity at work). The estimated mean indirect costs over a 4-week period was (Swiss Francs) CHF2005 (€1874) per patient, with loss of work productivity being the largest contributor.

Conclusion: Oesophageal cancer in Switzerland affects patients' professional and personal lives, resulting in lost time and informal caregiving, leading to societal costs.