Table 8.
Impact of productivity loss inclusion on incremental cost-effectiveness ratio (ICER) by cost element
| Impact1 | Absenteeism only2 (n = 98) | Presenteeism only3 (n = 1) | Absenteeism + presenteeism4 (n = 29) | Absenteeism + others (n = 32) | Unemployment/early retirement5 (n = 21) | Premature mortality6 (n = 22) | Other, not specified (n = 39) | Total7,8 (N = 208) |
|---|---|---|---|---|---|---|---|---|
| More favorable | 50 (51%) | 1 (100%) | 21 (72%) | 16 (50%) | 12 (57%) | 13 (59%) | 17 (44%) | 110 (53%) |
| No substantial impact | 10 (10%) | 0 (0%) | 0 (0%) | 5 (16%) | 4 (19%) | 0 (0%) | 1 (3%) | 16 (8%) |
| Less favorable | 5 (5%) | 0 (0%) | 4 (14%) | 4 (13%) | 2 (10%) | 1 (5%) | 5 (13%) | 18 (9%) |
| Not reported | 33 (34%) | 0 (0%) | 4 (14%) | 7 (22%) | 3 (14%) | 8 (36%) | 15 (38%) | 64 (31%) |
1Three of the included studies stated that productivity costs had a substantial impact without specifying the direction of impact. Studies were labeled as having a “more favorable” impact if inclusion of productivity costs resulted in a decrease in the ICER or an increase in the cost savings based on the specific cost figures provided or based on the comments of the author(s) when no specific figures were provided. Similarly, studies were labeled as having a “less favorable” impact if inclusion resulted in an increase in the ICER or a decrease in the cost savings. Studies were labeled as having “no substantial impact” if there was no change in the ICER with the inclusion of productivity costs or if their inclusion was reported by the author(s) as having no substantial impact and no specific figures were provided
2Chi-square test of “absenteeism + others” and “absenteeism only” excluding “not reported” yielded a p value of 0.389
3Chi-square test of “absenteeism + others” and “presenteeism only” excluding “not reported” yielded a p value of 0.759
4Chi-square test of “absenteeism + others” and “absenteeism + presenteeism” excluding “not reported” yielded a p value of 0.059
5Chi-square test of “absenteeism + others” and “unemployment + early/retirement” excluding “not reported” yielded a p value of 0.898
6Chi-square test of “absenteeism + others” and “premature mortality” excluding “not reported” yielded a p value of 0.113
7Thirty-one studies simply state that productivity loss was incorporated in modeling without explicitly specifying the exact elements
8Grand total is higher than the number of studies as some studies included more than one productivity cost element