BMC health services research · 2026
Empirical estimate for the indirect healthcare costs of sickle cell disease from a retrospective cohort study in England between 2007 and 2019.
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Rice Caoimhe T, Besser Martin, Baker Christine L, Colavecchia Carmine, Davidson Jennifer A, Brown Jeremy P, Barcelos Giovanna Tedesco
Аннотация
BACKGROUND: Sickle cell disease (SCD) imposes a considerable burden on patients and their families while also exerting economic pressure on high-prevalence countries. This retrospective cohort study estimated the societal cost of SCD in England, including productivity loss (PL) and loss of future income (LFI).
METHODS: In this retrospective cohort study, individuals aged ≥ 12 years with SCD were identified between 01 April 2007 and 31 March 2019 using linked healthcare data from the Clinical Practice Research Datalink Aurum, Hospital Episode Statistics, and Office for National Statistics death registrations. PL was calculated based on time spent hospitalised, attending healthcare appointments, or on certified sick days, using average wages for England stratified by age for the same year the PL occurred. LFI due to unemployment, medical retirement, or death was calculated from the age at first occurrence until age 68 years. Average annual earnings for FY2021/2022 were applied by age decile and discounted at 3.5%. Expected income increased with age decile.
RESULTS: Overall, 9,272 patients with SCD were included, with a mean age of 35.5 years and a median follow-up of 7 years. Mean annualised (per patient per year [PPPY]) productive time lost due to hospital stays was 5.5 days. Individuals spent 2.7 days PPPY in outpatient care, 3.6 days PPPY attending primary care appointments, 3.3 days PPPY in emergency departments, and 2.2 days PPPY sick at home. The mean annualised PL for these sickness and healthcare attendances was £1,821 PPPY, equivalent to 3.1 weeks of average UK weekly earnings in 2021. For the 6% of patients (555/9,272) who experienced an LFI event, they were estimated to lose an average of £511,236 over their lifetime.
CONCLUSIONS: Patients with SCD and their families had an estimated PL equivalent to 3.1 weeks of average UK weekly earnings in 2021 per individual annually. For patients with SCD who died or were incapacitated before retirement age, lifetime LFI was more than half a million pounds.
TRIAL REGISTRATION: Not applicable.
METHODS: In this retrospective cohort study, individuals aged ≥ 12 years with SCD were identified between 01 April 2007 and 31 March 2019 using linked healthcare data from the Clinical Practice Research Datalink Aurum, Hospital Episode Statistics, and Office for National Statistics death registrations. PL was calculated based on time spent hospitalised, attending healthcare appointments, or on certified sick days, using average wages for England stratified by age for the same year the PL occurred. LFI due to unemployment, medical retirement, or death was calculated from the age at first occurrence until age 68 years. Average annual earnings for FY2021/2022 were applied by age decile and discounted at 3.5%. Expected income increased with age decile.
RESULTS: Overall, 9,272 patients with SCD were included, with a mean age of 35.5 years and a median follow-up of 7 years. Mean annualised (per patient per year [PPPY]) productive time lost due to hospital stays was 5.5 days. Individuals spent 2.7 days PPPY in outpatient care, 3.6 days PPPY attending primary care appointments, 3.3 days PPPY in emergency departments, and 2.2 days PPPY sick at home. The mean annualised PL for these sickness and healthcare attendances was £1,821 PPPY, equivalent to 3.1 weeks of average UK weekly earnings in 2021. For the 6% of patients (555/9,272) who experienced an LFI event, they were estimated to lose an average of £511,236 over their lifetime.
CONCLUSIONS: Patients with SCD and their families had an estimated PL equivalent to 3.1 weeks of average UK weekly earnings in 2021 per individual annually. For patients with SCD who died or were incapacitated before retirement age, lifetime LFI was more than half a million pounds.
TRIAL REGISTRATION: Not applicable.