Table 3.
Effect of biological treatment on presenteeism studies.
| Author | Measure | Comparator | Difference | ∆ | 95%CI | Significant or Not | Costs |
|---|---|---|---|---|---|---|---|
| RCT Trial | |||||||
| Anis 2009 [23] | WPAI: Work productivity loss at work (%) |
MTX vs. ETA + MTX | 23.1 vs. 15.6 | −7.5 | (−11.2; −4.2) | YES | NA |
| WPAI: Lost work days due to presenteeism |
Scenario I: 34.0 vs. 28.6 Scenario II: 38.9 vs. 29.7 |
−5.4 −9.3 |
(−13.5; 2.8) (−16.3; −2.5) |
NO YES |
−£382 −£657 |
||
| WPAI: Total work productivity loss, days |
Scenario I: 99.6 vs. 57.6 Scenario II: 83.3 vs. 51.9 |
−42.0 −31.3 |
(−69.0; −15.7) (−50.2; −12.6) |
YES YES |
−£2968 −£2212 |
||
| WLQ: work productivity loss at work (%) | 6.2 vs. 4.8 | −1.4 | (−2.1; −0.7) | YES | NA | ||
| WLQ: Lost work days due to presenteeism |
Scenario I: 9.1 vs. 8.9 Scenario II: 10.4 vs. 9.2 |
−0.3 −1.3 |
(−2.3; 1.8) (−2.8; 0.3) |
NO NO |
−£21 −£92 |
||
| WLQ: Total work productivity loss, days |
Scenario I: 74.7 vs. 37.8 Scenario II: 54.8 vs. 31.5 |
−36.9 −23.3 |
(−66.9; −7.6) (−43.0; −4.2) |
YES YES |
−£2607 −£1646 |
||
| Observational trials | |||||||
| Zhang 2008 [24] | Absenteeism, mean | ADA vs. baseline | ND | ND | ND | ND | Lost productivity costs, past two weeks: –$4.48 |
| Augustsson 2010 [25] | Overall | Unadjusted model | Improvement: first year: 4.2 h/week, thereafter: 0.5 h/week |
The productivity gains for society in patients continuing treatment would total €28,000 over 5 years. |
Note that these estimates only apply to patients who do not discontinue treatment, a group that may be difficult to identify before treatment initiation. |
||
| Adjusted model b | Improvement: first year: 4.1 h/week, thereafter: no change |
The productivity gains for society in patients continuing treatment would total €27,000 over 5 years. This corresponds to approximately 40% of the annual anti-TNF drug cost. |
|||||
| Hone 2013 [26] | Hours gained/patient (presenteeism) | ETA baseline vs. 6 months | 205.2 vs. 189.7/ 39.7 ± 24.5 vs. 24.8 ± 22.5 |
15.5/ −13.5 ± 23.3 |
ND/ (−17.0; −9.9) |
ND/ YES |
Economic gain/patient: $5328 |
| Tanaka 2018 [28] | Presenteeism | Baseline vs. week 48 | ND | ND | ND | ND | Human capital method (cumulative reduction): PW: $5836 (mean) PTW: $2726 (mean) HM: NA |
ADA—adalimumab, DMARD—disease modifying antirheumatic agent, ETA—etanercept, IFX—infliximab, MTX—methotrexate, PW—paid worker employed for ≥35 h/week; PTW—part-time worker employed for <35 h/week; HM—home maker non-employed; WLQ—Work Limitations Questionnaire; (a) Baseline and 12 months’ status for the entire cohort, extrapolated to annual costs. Work capacity is expressed as full time equivalent—that is, full time work represents 100%, part time work actual percentage, and not working 0%; (b) own estimation based on data presented in publication; (c) using the friction cost method for valuation of productivity losses, the infliximab group had borderline higher productivity losses (€14,597 vs. €12,018; adjusted mean difference €2134; 95%CI: −284; 4535), and (as with the human capital method) higher total costs (€42,084 vs. €22,382; adjusted mean difference €19,090; 95%CI: 15,564; 22,252) than the conventional treatment group; DMARD—disease-modifying antirheumatic drug.