SLIDE 1 The burden of cancer in emerging economies: Productivity loss as an alternative perspective
Alison Pearce, Paul Hanly, Linda Sharp, Isabelle Soerjomataram
ISPOR 2015
SLIDE 2 Cancer in emerging economies
Developing countries 54% Developed countries 46%
Cancer diagnoses
Developing countries 64% Developed countries 36%
Cancer deaths
SLIDE 3 BRICS countries
World’s Population World’s Land area World’s GDP
SLIDE 4
Burden of cancer
Everyone’s work contributes to the economy, and not working represents a loss of this contribution to society
SLIDE 5
Aim
To estimate the value of lost productivity due to cancer-related premature mortality in Brazil, Russia, India, China and South Africa (BRICS) in 2012
SLIDE 6 Methods & Data
- Incidence-based, human capital approach
- GLOBOCAN data
- Cancer mortality rates
- OECD & ILO data
- Workforce participation & unemployment
- Wages & future wage growth
- Retirement ages
- Local currency calculations converted to USD
using PPP and inflation to 2012
SLIDE 7
Demographic inputs
Population (millions) Cancer deaths Life expectancy Brazil 201 222,505 73.8 China 1,357 2,194,746 75.3 India 1,211 673,098 66.4 Russia 144 294,522 68.0 South Africa 52 46,953 57.0
SLIDE 8
Wage inputs
Monthly wage (USD) Wage growth rate Brazil $1,069 2.0% China $172 3.7% India $415 4.2% Russia $7,100 2.4% South Africa $2,631 2.8%
SLIDE 9 Workforce inputs
Gender Participation Unemployment Retire
(eg 40-45) (eg 40-45)
age Brazil Male 93.56 2.24 65 Female 71.44 4.83 60 China Male 96.50 1.87 60 Female 84.82 2.60 50 India Male 98.10 1.12 60 Female 37.10 1.35 58 Russia Male 94.23 4.07 58 Female 91.24 3.47 55 South Africa Male 85.45 15.96 60 Female 67.07 17.24 60
SLIDE 10 Deaths & YPLL
100 200 300 400 500 600 Male Female Male Female Male Female Male Female Male Female Brazil China India Russia Sth Africa
Deaths & Years of Productive Life Lost
Deaths (1,000s) YPLL (10,000s)
SLIDE 11 Total cost & cost per death
$0 $20,000 $40,000 $60,000 $80,000 $100,000 $0 $5 $10 $15 $20 $25 Male Female Male Female Male Female Male Female Male Female Brazil China India Russia Sth Africa Billions
Total cost and cost per death
Total Cost Cost per death
SLIDE 12 Results by cancer
0% 20% 40% 60% 80% 100% Brazil China India Russia South Africa
Brain, nervous system Prostate Cervix uteri Breast Melanoma of skin Lung Liver Colorectum Stomach Oesophagus
SLIDE 13 Sensitivity Analyses
- Divide Chinese data by urban and rural
- Increase workforce participation in India
- Increase retirement ages in China & Russia
- Changing growth rates & discounting
No major changes to the findings
SLIDE 14 Limitations
- Concerns about equity with the Human
Capital Approach
- Lack of data
- Assumptions around employment (informal
economies and household production)
- But… valuing cancer related lost
productivity can provide policy makers with an additional perspective when identifying priorities for cancer prevention and control
SLIDE 15 Implications
- Prevention activities are important, and
need to extend beyond tobacco control
- Earlier detection and improved treatment
availability to reduce mortality may be economically efficient
- Potential increase in cancer burden
through ageing, urbanisation and westernisation
SLIDE 16 Acknowledgements
- International collaborators: Freddie Bray, Prakash Gupta,
You-Lin Qiao, Freddy Sitas, Anton Barchuk, Marianna de Camargo Cancela
- COST Action IS1211 CANWON funded a Short Term
Scientific Mission for Alison Pearce, to IARC, to establish this project
- Alison Pearce is funded by an HRB ICE Award
- The NCRI is funded by the Department of Health
SLIDE 17
Contacts
Alison Pearce ICE Post-doctoral Research Fellow National Cancer Registry Ireland a.pearce@ncri.ie @aliepea
