Work absenteeism and disability days after diagnosis among patients with AML and caregivers.
Authors: LeBlanc Thomas William , Young Christopher , Packnett Elizabeth R. , Xie Bin , Lillehaugen Timothy , Block Alana , Bernacki Katarzyna , Touya Maelys , Pandya Bhavik J. 
Published: June 2023

e19002 Background: Treatment for acute myeloid leukemia (AML) includes intensive chemotherapy and/or hematopoietic stem cell transplant, and patients usually require extended hospital stays and absence from work. Caregivers may also take workplace absence to provide care during and after treatment. As data on the indirect burden of AML are underreported, we aimed to understand the impact of work absenteeism (ABS) and disability days among patients with AML and caregivers. Methods: This non-interventional, retrospective analysis of healthcare claims data was conducted using MarketScan Databases containing ABS data. Two cohorts were analyzed: patients newly diagnosed with AML between January 1, 2009 and December 1, 2019 (index period), and caregivers with an adult family member newly diagnosed with AML during the index period. All participants were full-time employees, aged 18–64 years, and had ≥12 months of continuous enrollment prior to index date and ≥30 days of continuous enrollment after index date. The index date was the date of first AML diagnosis for patients, or the date of the linked family member’s first AML diagnosis for caregivers. Participants were followed for ≥30 days up to 3 years, until the end of continuous enrollment, end of database eligibility, or end of the study period. Participants who were pregnant or in families with > 1 member with AML were excluded. Days of work loss and associated wage loss were calculated for each work loss type: ABS, short-term disability (STD), and long-term disability (LTD). Results: This analysis included 1,037 patients with AML and 781 caregivers. From baseline to follow-up (FU) period, the proportion of patients reporting ABS numerically decreased from 72.8% to 62.7% (p = 0.054), and changes in ABS days per patient per month (PPPM) (2.21– 2.10, p = 0.735) or ABS-related wage loss PPPM ($562–$511, p = 0.516) were not statistically significant. However, the proportion of patients reporting STD and LTD significantly increased (24.6%–50.0%, p < 0.001, and 4.0%–20.0%, p < 0.001, respectively). The number of days PPPM lost due to STD and LTD significantly increased (0.85–4.94, p < 0.001, and 0.24–1.40, p < 0.001), as did STD- and LTD-related wage loss PPPM ($203–$1194, p < 0.001, and $57–$330, p < 0.001). Among caregivers, the proportion reporting ABS and ABS days PPPM were similar between baseline and FU periods (83.2%–83.9%, p = 0.871, and 2.41–2.64, p = 0.315). The proportion of caregivers with STD claims significantly increased (5.4%–11.8%, p < 0.001), and days PPPM lost due to STD and associated wage loss PPPM numerically increased (0.15–0.25, p = 0.057 and $38–$60, p = 0.087). Conclusions: Following AML diagnosis, the proportion of patients with STD and LTD leave increased significantly, while absenteeism did not change significantly. Days of STD leave also increased among caregivers. Future research is needed to determine how work loss varies by AML treatment type and/or sequencing.