Abstract
Objective: To assess productivity costs incurred by rheumatoid arthritis, comprising paid as well as household productivity costs, from a societal perspective, using different methods.
Methods: A questionnaire on productivity, including items of the Health and Labour Questionnaire, was completed by 576 patients with rheumatoid arthritis (mean disease duration seven years). The friction cost (FC) method using the gross national wage per hour was applied to estimate paid productivity, and the market equivalent was used to value loss of household productivity. Sensitivity analyses to estimate paid productivity costs among patients of working age included the human capital (HC) method and an alternative source, namely the "added value", to value loss of paid productivity.
Results: In the total study population, mean (SD) annual costs from loss of paid productivity according to the FC method were estimated to be €278 (€1559) and mean annual household productivity costs were €2045 (€3882). When using the HC method, mean annual costs increased to an average of €4434 (€9957). When using the added value of production, average FC costs increased from €455 to €540 among patients of working age.
Conclusions: Costs from loss of household productivity in rheumatoid arthritis were seven times higher than costs from loss of paid productivity, assessed by the FC method. The high paid productivity costs when using the HC method reflect the high work disability rate in rheumatoid arthritis. As the method of measuring and source of valuing productivity loss has an important influence on the costs, a consensus to standardise these issues is desirable.
Full Text
The Full Text of this article is available as a PDF (99.3 KB).
Figure 1.
Mean functional disability (Health Assessment Questionnaire) score for patients who required (in)formal home care (black bars) and for those who did not (grey bars). Whiskers = SD.
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Allaire S. H., Anderson J. J., Meenan R. F. Reducing work disability associated with rheumatoid arthritis: identification of additional risk factors and persons likely to benefit from intervention. Arthritis Care Res. 1996 Oct;9(5):349–357. doi: 10.1002/1529-0131(199610)9:5<349::aid-anr1790090503>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
- Boonen A., van der Heijde D., Landewé R., Spoorenberg A., Schouten H., Rutten-van Mölken M., Guillemin F., Dougados M., Mielants H., de Vlam K. Work status and productivity costs due to ankylosing spondylitis: comparison of three European countries. Ann Rheum Dis. 2002 May;61(5):429–437. doi: 10.1136/ard.61.5.429. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Briggs A., Gray A. The distribution of health care costs and their statistical analysis for economic evaluation. J Health Serv Res Policy. 1998 Oct;3(4):233–245. doi: 10.1177/135581969800300410. [DOI] [PubMed] [Google Scholar]
- Clarke A. E., Penrod J., St Pierre Y., Petri M. A., Manzi S., Isenberg D. A., Gordon C., Senecal J. L., Fortin P. R., Sutcliffe N. Underestimating the value of women: assessing the indirect costs of women with systemic lupus erythematosus. Tri-Nation Study Group. J Rheumatol. 2000 Nov;27(11):2597–2604. [PubMed] [Google Scholar]
- Clarke A. E., Penrod J., St Pierre Y., Petri M. A., Manzi S., Isenberg D. A., Gordon C., Senecal J. L., Fortin P. R., Sutcliffe N. Underestimating the value of women: assessing the indirect costs of women with systemic lupus erythematosus. Tri-Nation Study Group. J Rheumatol. 2000 Nov;27(11):2597–2604. [PubMed] [Google Scholar]
- Gabriel S. E., Crowson C. S., Campion M. E., O'Fallon W. M. Indirect and nonmedical costs among people with rheumatoid arthritis and osteoarthritis compared with nonarthritic controls. J Rheumatol. 1997 Jan;24(1):43–48. [PubMed] [Google Scholar]
- Koopmanschap M. A., Rutten F. F. A practical guide for calculating indirect costs of disease. Pharmacoeconomics. 1996 Nov;10(5):460–466. doi: 10.2165/00019053-199610050-00003. [DOI] [PubMed] [Google Scholar]
- Koopmanschap M. A., van Ineveld B. M. Towards a new approach for estimating indirect costs of disease. Soc Sci Med. 1992 May;34(9):1005–1010. doi: 10.1016/0277-9536(92)90131-9. [DOI] [PubMed] [Google Scholar]
- Lajas Cristina, Abasolo Lydia, Bellajdel Boutayeb, Hernández-García César, Carmona Loreto, Vargas Emilio, Lázaro Pablo, Jover Juan A. Costs and predictors of costs in rheumatoid arthritis: a prevalence-based study. Arthritis Rheum. 2003 Feb 15;49(1):64–70. doi: 10.1002/art.10905. [DOI] [PubMed] [Google Scholar]
- Liang M. H., Larson M., Thompson M., Eaton H., McNamara E., Katz R., Taylor J. Costs and outcomes in rheumatoid arthritis and osteoarthritis. Arthritis Rheum. 1984 May;27(5):522–529. doi: 10.1002/art.1780270507. [DOI] [PubMed] [Google Scholar]
- McIntosh E. The cost of rheumatoid arthritis. Br J Rheumatol. 1996 Aug;35(8):781–790. doi: 10.1093/rheumatology/35.8.781. [DOI] [PubMed] [Google Scholar]
- Meenan R. F., Yelin E. H., Henke C. J., Curtis D. L., Epstein W. V. The costs of rheumatoid arthritis. A patient-oriented study of chronic disease costs. Arthritis Rheum. 1978 Sep-Oct;21(7):827–833. doi: 10.1002/art.1780210714. [DOI] [PubMed] [Google Scholar]
- Merkesdal S., Ruof J., Schöffski O., Bernitt K., Zeidler H., Mau W. Indirect medical costs in early rheumatoid arthritis: composition of and changes in indirect costs within the first three years of disease. Arthritis Rheum. 2001 Mar;44(3):528–534. doi: 10.1002/1529-0131(200103)44:3<528::AID-ANR100>3.0.CO;2-U. [DOI] [PubMed] [Google Scholar]
- Newhall-Perry K., Law N. J., Ramos B., Sterz M., Wong W. K., Bulpitt K. J., Park G., Lee M., Clements P., Paulus H. E. Direct and indirect costs associated with the onset of seropositive rheumatoid arthritis. Western Consortium of Practicing Rheumatologists. J Rheumatol. 2000 May;27(5):1156–1163. [PubMed] [Google Scholar]
- Rice D. P., Hodgson T. A., Kopstein A. N. The economic costs of illness: a replication and update. Health Care Financ Rev. 1985 Fall;7(1):61–80. [PMC free article] [PubMed] [Google Scholar]
- Ruof J., Hülsemann J. L., Mittendorf T., Handelmann S., von der Schulenburg J. M., Zeidler H., Merkesdal S. Costs of rheumatoid arthritis in Germany: a micro-costing approach based on healthcare payer's data sources. Ann Rheum Dis. 2003 Jun;62(6):544–549. doi: 10.1136/ard.62.6.544. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thompson S. G., Barber J. A. How should cost data in pragmatic randomised trials be analysed? BMJ. 2000 Apr 29;320(7243):1197–1200. doi: 10.1136/bmj.320.7243.1197. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Verstappen S. M. M., Bijlsma J. W. J., Verkleij H., Buskens E., Blaauw A. A. M., ter Borg E. J., Jacobs J. W. G., Utrecht Rheumatoid Arthritis Cohort Study Group Overview of work disability in rheumatoid arthritis patients as observed in cross-sectional and longitudinal surveys. Arthritis Rheum. 2004 Jun 15;51(3):488–497. doi: 10.1002/art.20419. [DOI] [PubMed] [Google Scholar]
- Verstappen S. M. M., Verkleij H., Bijlsma J. W. J., Buskens E., Kruize A. A., Heurkens A. H. M., Van Der Veen M. J., Jacobs J. W. G. Determinants of direct costs in Dutch rheumatoid arthritis patients. Ann Rheum Dis. 2004 Jul;63(7):817–824. doi: 10.1136/ard.2003.014340. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yelin E., Meenan R., Nevitt M., Epstein W. Work disability in rheumatoid arthritis: effects of disease, social, and work factors. Ann Intern Med. 1980 Oct;93(4):551–556. doi: 10.7326/0003-4819-93-4-551. [DOI] [PubMed] [Google Scholar]
- Yelin E. The costs of rheumatoid arthritis: absolute, incremental, and marginal estimates. J Rheumatol Suppl. 1996 Mar;44:47–51. [PubMed] [Google Scholar]
- Young A., Dixey J., Kulinskaya E., Cox N., Davies P., Devlin J., Emery P., Gough A., James D., Prouse P. Which patients stop working because of rheumatoid arthritis? Results of five years' follow up in 732 patients from the Early RA Study (ERAS). Ann Rheum Dis. 2002 Apr;61(4):335–340. doi: 10.1136/ard.61.4.335. [DOI] [PMC free article] [PubMed] [Google Scholar]
- van Jaarsveld C. H., Jacobs J. W., Schrijvers A. J., van Albada-Kuipers G. A., Hofman D. M., Bijlsma J. W. Effects of rheumatoid arthritis on employment and social participation during the first years of disease in The Netherlands. Br J Rheumatol. 1998 Aug;37(8):848–853. doi: 10.1093/rheumatology/37.8.848. [DOI] [PubMed] [Google Scholar]
- van Roijen L., Essink-Bot M. L., Koopmanschap M. A., Bonsel G., Rutten F. F. Labor and health status in economic evaluation of health care. The Health and Labor Questionnaire. Int J Technol Assess Health Care. 1996 Summer;12(3):405–415. doi: 10.1017/s0266462300009764. [DOI] [PubMed] [Google Scholar]