Mercer Marsh Benefits

Employers can (and should) support their employees through cancer

Cancer cases are increasing worldwide, but advancements in research have improved treatment options. Employers need to redefine cancer care and support employees in medical, financial, professional, and social aspects. Steps should be taken to protect workforce health and well-being from the impact of cancer. Learn more, including actions employers can take.

Imagine Sarah, a 50-year-old accountant working for a multinational company. She has been diagnosed with breast cancer. Her cancer journey will be influenced by several factors, including the country where she lives and the benefits she might have through her job.

For example:

If Sarah lives in China, she might receive a lump sum cash payment upon being diagnosed with cancer, which comes with an exclusion on any future private medical critical illness coverage.¹
If Sarah lives in Panama, insurers typically cover 80% of cancer care after the deductible is met. Market practice in paid leave permits 12 months with partial pay through government programs.
If Sarah lives in Spain, the public healthcare system covers medical expenses fully, but long wait times may result in delayed screening and treatment.²

In all three scenarios, Sarah’s odds of positive medical outcomes will vary based on when her disease is diagnosed and how it is treated and managed. Likewise, her odds of maintaining her financial health will vary based on a number of factors, including: the cost of her care; the impact of her disease and treatment on her ability to work; and the supplemental benefits and leave policies provided by public provisions and her employer. Regardless of where she lives, Sarah’s cancer experience will be mediated by the practical supports her job may provide her, including medical benefits, access to paid leave, flexible working, and social support networks.

Cancer cases are on the rise globally; a 77% increase in cancer diagnosis is expected over the next three decades.³ At the same time, research advances have improved cancer treatment, making intervention options more effective than ever. This duality demands the world —including global employers — redefine strategic short- and long-term cancer care. How can companies support employees like Sarah medically, financially, professionally, and socially? What steps can and should employers take to protect their workforce health and holistic well-being from the ravages of cancer?

Cancer affects everyone everywhere, whether directly or indirectly. One in every five people — from all segments of the population — will be diagnosed at some point in their life.⁴

Cancer is an employer issue.

Cancer is a top five condition by cost globally.⁵
Being diagnosed with cancer is an emotionally charged, confusing and stressful time for employees, that impacts their productivity in life and at work.
Explosive growth in new treatments have shown increased effectiveness at keeping people alive and productive while significantly impacting cancer spend.
Over 70% of the employed population worldwide identifies as a family caregiver.⁶

There is an association between support at work and positive employee health and well-being.

Working can benefit those with cancer both psychologically and financially.⁷
Perceived social connectedness can increase cancer survival; the absence of it lowers quality of life and increases mortality risk.⁸
Cancer survivors are more likely to not work. Research shows that those with accommodating employers are more likely to keep working after treatment.⁹
Employed cancer caregivers struggle balancing work and caregiving; they report a wide variety of work-related and mental health impacts including presenteeism, and stress.¹⁰

Employers can support employees with cancer by balancing empathy and economics in total rewards, benefits and organizational culture.

Almost half of all cancers are preventable.¹¹ Although early detection can increase survival rates, coverage for and access to clinical preventive services such as screenings and vaccinations varies globally.
There are approximately 32 million cancer survivors worldwide; many live with it as a chronic disease.¹² This number will grow given improvements in cancer screening, increasingly effective cancer treatment and an aging population. Every workforce includes cancer survivors; organizational culture should embrace them.
The global economic cost of cancers from 2020 to 2050 is estimated to be $25.2 trillion*; this ever-increasing cost of new data, treatments and technologies in cancer are transforming employer responsibilities and placing a strain on health benefits.¹³

The evolving cancer challenge

According to the World Health Organization (WHO), cancer is a leading cause of death globally: in 2022, there were 20 million new cases and 9.7 million deaths due to cancer, which translates into approximately one death in every nine for men and one in every 12 for women.¹⁴ The disease does not respect age: although half of all cancer cases occur in people over the age of 70, cancer is affecting a wider range of age groups and demographics than ever before. Rates are rapidly increasing among younger cohorts in the workforce. Worldwide, the number of cancer cases in those under age 50 are up 80% in the past three decades.¹⁵

There is nothing universal about cancer apart from its prevalence. Cancer types and rates vary across regions and demographics including income, race, gender, and sexual orientation. Access to cancer treatment and support also varies widely across regions and demographic groups. There is no one-size-fits-all approach globally to prioritizing cancer action and providing adequate care. Employers need to understand the risk cancer poses to its workforce both globally and locally.

Cancer care itself is ever-more costly and complex. As noted above, the estimated global cost of cancer from 2020 to 2050 is projected to be a staggering $25.2 trillion. Mercer Marsh Benefit’s Health Trends 2024 report cites cancer as a global top cause of claims costs in 2022. New data and technologies in cancer prevention, diagnosis and treatment, for example genomic testing, gene therapy, and CAR T-cell therapy will create even greater financial pressures. This confluence of factors means that employers should be strategic in their approach to cancer care, defining global guiding principles for action and locally addressing coverage and gaps where possible.

Setting the human costs aside, cancer impacts the corporate bottom line directly and indirectly.¹⁶ Beyond healthcare costs, it may impact both individual careers and wider organizational productivity, affect careers, and demand active management.

Cancer impacts both individuals and organizations

Source: Mercer Marsh Benefits

The cancer care continuum

Source: Mercer Marsh Benefits

Addressing cancer in the workforce should focus on ensuring there is adequate support for the employee through all phases of their health journey.

Prevention

Identifying or detecting cancer is the first line of defense. Strategy considerations should include:

Reviewing employee access to clinical preventive services globally. How are employees and their families able to get their recommended services? Are there obstacles to doing so, such as wait times, or lack of cover?
Ensuring employees and their families can access clinical preventive services when employer-sponsored medical benefits are the means for doing so. Across worldwide employee populations, benefits such as preventive cancer screening and access to recommended vaccinations are considered very helpful.¹⁷ To that end, they should be designed to encourage take-up, rather than deter it.
Providing employee education about the importance of lifestyle modification. Globally, smoking, alcohol use, poor diet and limited physical activity are top contributors to cancer.
Linking employees to available public screening options. Private medical coverage may not be the best answer in all geographies.

Diagnosis

Early and accurate diagnosis can significantly change the outcome for the employee and impact the cost of treatment. Helping employees identify and access the most appropriate providers (as first and second opinions) is key to ensuring the accurate diagnosis and utilization of evidence-based clinical pathways. Globally, look for insurer partners (internationally and locally) that can support these aims.

A tailored approach is important in cancer care

Population and geographic variations in cancer diagnosis, treatment and mortality underscore the importance of tailored education, comprehensive benefits and culturally and contextually relevant support programs. Disparities should be considered when reviewing benefit plans and programs for inclusivity and health equity and to remove bias. Focusing solely on only the most prevalent cancers may discriminate against specific racial or ethnic minorities or employee groups, not to mention leaving some countries or regions with limited access to needed care.

Treatment

Steering employees to high-quality care and removing barriers to access is critical as misdiagnosis and incorrect treatment can result in poorer health outcomes. Support employees seeking treatment locally or via a center of excellence by means of intentional and well-considered plan design. This can be accomplished with effective global benefit governance, improved benefit navigation and second medical opinions where appropriate.

Thanks to improved treatments, many now live with cancer as a chronic disease requiring long-term treatment. Cancer survivors may require years of rehabilitative care, lifelong screenings and follow-ups — including recurrence requiring additional treatments and care. This influences medical benefit plan coverage and design.

It’s vital that companies are clear about their local and global obligations (to employees, to communities, to the business and to shareholders) and act on them.

Balancing coverage adequacy and sufficiency

The economic burden of cancer care worldwide is high and continues to grow. This directly impacts employer sponsors of health benefits globally and their existing and projected medical spend. It is vital that companies are clear about their local and global obligations (to employees, to communities, to the business and to shareholders) and act on them.

Other support

Patients and their caregivers are all involved in a long-term journey that impacts all aspects of their well-being. Employers have a vested interest in addressing a Total Well-being strategy, as it mediates the relationship an employee has with work, at work and in life. That includes ensuring that benefits, policies, processes and services are defined to support employees with cancer or in recovery from it, as well as the family and/or community directly supporting those employees. Establishing an authentic culture of caring and a safe working environment are first steps to being a relatable and trusted employer.

Total well-being is a complete strategy

Source: Mercer Marsh Benefits

Conclusion

Cancer incidence and related spend has and will continue to increase steadily. As the earlier example of Sarah highlights, the supports available can vary dramatically depending on diagnosis, location, demographics and more. As the cancer care landscape rapidly advances, we see evolution in personalized and precision medical treatments, early detection methods and additional practical supports for employees with cancer and their caregivers. Companies globally are recognizing the value of pledging^* to create a positive workplace environment that supports impacted employees, and of putting in place a consistent set of supports that help to drive Total Well-being. At the same time, however, companies will need to make tough choices in their approach to medical benefits globally, answering questions of coverage adequacy and sufficiency while constrained by budget limitations. Mercer Marsh Benefits’ global team of clinicians and content specialists can support companies pursuing balance in these potentially divergent goals.

Series: This is part one of a series. Part two ’Practical steps every employer can take to support employees impacted by cancer’ outlines actionable steps companies can take to support employees impacted by cancer.

* The Working with Cancer Pledge launched in 2023 to bring attention to issues people with cancer face in the workplace.

Citations:

¹. Mercer. Worldwide Benefit and Employment Guidelines: China. 2024

². Mercer. Worldwide Benefit and Employment Guidelines: Spain. 2024.

³. World Health Organization. “Global cancer burden growing, amidst mounting need for services.” Feb. 1, 2024.

⁴. Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. “Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.” CA Cancer J Clin. Apr. 4, 2024.

⁵. Mercer Marsh Benefits. Health Trends 2024.

⁶. Henderson A, Johal S. “Supporting Employee Caregivers Starts with Better Data.” Harvard Business Review. Apr. 15, 2022.

⁷. Blinder VS, Gany FM. “Impact of Cancer on Employment.” J Clin Oncol. Feb. 1, 2020. Volume 38 Issue 4, pp. 302–09.

⁸. Boen CE, Barrow DA, Bensen JT, Farnan L, Gerstel A, Hendrix LH, Yang YC. “Social Relationships, Inflammation, and Cancer Survival.” Cancer Epidemial Biomarkers Prev. May 2018. Volume 27 Issue 5, pp. 541–9.

⁹. Blinder V, Eberle C, Patil S, Gany FM, Bradley CJ. “Women With Breast Cancer Who Work for Accommodating Employers More Likely To Retain Jobs After Treatment. Health Aff (Millwood).” Feb. 1, 2017. Volume 36 Issue 2, pp. 274-81.

¹⁰. Xiang E, Guzman P, Mims M, Badr H. “Balancing Work and Cancer Care: Challenges Faced by Employed Informal Caregivers.” Cancers (Basel). Aug. 27, 2022. Volume 14 Issue 17, p. 4146.

¹¹. Guglielmi G. “Almost Half of Cancer Deaths are Preventable.” Nature. Aug. 31, 2022.

¹². Merollini KMD, Gordon LG, Aitken JF, Kimlin MG. “Lifetime Costs of Surviving Cancer: A Queensland Study (COS-Q): Protocol of a Large Healthcare Data Linkage Study.” Int J Environ Res Public Health. Apr. 20, 2020. Volume 17 Issue 8, p. 2831.

¹³. “Estimate of the Global Economic Cost of the Most Prevalent Cancers in 204 Countries from 2020 to 2050.” ESMO Oncology News. Mar. 13, 2023.

¹⁴. Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024 May-Jun;74(3):229-263.

¹⁵. Zhao J, Xu L, Sun J, et al. “Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019.” BMJ Oncology. 2023;2.

¹⁶. The Economist Intelligence Unit. Cancer in the workplace. February 2017.

¹⁷. Mercer Marsh Benefits. Health on Demand 2023.

Senior doctor using his tablet computer at work (color toned image)

Expertise

Employers can (and should) support their employees through cancer