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Comparative Study
. 2025 Jun 5;33(7):543.
doi: 10.1007/s00520-025-09561-z.

Extended disability leave and related costs among employed patients with versus without graft-versus-host disease following hematopoietic stem cell transplantation

Jingbo Yu  1 , Valkal Bhatt  2 , John Galvin  2 , Krutika Jariwala-Parikh  3 , Ellen Thiel  3
Affiliations
Comparative Study

Extended disability leave and related costs among employed patients with versus without graft-versus-host disease following hematopoietic stem cell transplantation

Jingbo Yu et al. Support Care Cancer. .

Abstract

Purpose: Post-hematopoietic stem cell transplantation (HSCT) graft-versus-host disease (GVHD) is associated with considerable healthcare costs, and impaired productivity may represent an additional financial burden. This analysis quantified GVHD-associated indirect costs of productivity loss by comparing work-related disability leave claims between patients with versus without GVHD.

Methods: Patients with claims for HSCT in the IBM® MarketScan Commercial Database and the Health and Productivity Management Database between 1/1/09-12/31/19 and associated short- or long-term disability claims were included.

Results: Of 354 patients with GVHD and 2629 patients without GVHD included in the analysis, a significantly greater percentage of patients with versus without GVHD had claims for short-term disability (GVHD, 43.5%; non-GVHD, 29.2%; P < 0.001), long-term disability (GVHD, 19.9%; non-GVHD, 6.3%; P < 0.001) or a combination of both (GVHD, 53.5%; non-GVHD, 30.5%; P < 0.001). Disability leaves were, on average, longer for patients with GVHD versus without GVHD (short-term, 103 vs 59 days, P < 0.001; long-term, 120 vs 92 days, P < 0.001). Mean indirect costs of workdays lost due to disability leave were significantly higher among those with versus without GVHD (short-term, $13,180 vs $7504, P < 0.001; long-term, $15,441 vs $11,850, P < 0.001). Mean all-cause healthcare costs were significantly higher among those with versus without GVHD (short-term leave: $295,241 vs $95,937, P < 0.001; long-term leave: $312,691 vs $94,285, P < 0.001).

Conclusions: Most full-time employed patients with GVHD took disability leave, accounting for approximately half (127/261) of their total workdays, incurring higher indirect costs than patients without GVHD. Additionally, all-cause healthcare costs were threefold higher in patients with versus without GVHD.

Keywords: Costs; Disability; Graft-versus-host disease; Hematopoietic stem cell transplantation; Productivity.

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Conflict of interest statement

Declarations. Ethics approval: Ethics approval was not applicable. Consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: JY, VB, and JG are employees and stockholders of Incyte Corporation. ET is an employee of Merative, the company commissioned by Incyte Corporation to perform this analysis. KJ-P was an employee of Merative at the time of the study.

Figures

Fig. 1
Fig. 1
(a) Patients With ≥ 1 Short- or Long-Term Disability Leave During 12-Month Follow-Up and (b) Mean (SD) Time on Leave. GVHD, graft-versus-host disease
Fig. 2
Fig. 2
Mean (SD) (a) Indirect Costs due to Missed Workdays on Disability Among Patients With Short- and Long-Term Disability Leave and (b) Total Direct All-Cause Healthcare Costs During 12-Month Follow-Up Among Patients With Short- and Long-Term Disability Leave. GVHD, graft-versus-host disease
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