Assessing the Cost of Work Productivity Loss in a Privately Insured US Population With Inflammatory Bowel Diseases

OBJECTIVES: To determine the cost of work productivity loss (WPL) associated with inflammatory bowel diseases (IBD).

METHODS: Newly diagnosed adult IBD patients (with Crohn’s disease [CD] or ulcerative colitis [UC]) and controls were selected from the Merative™ MarketScan Research Commercial Claims and Encounters database based on diagnosis codes (January, 2000–December, 2021), with a subset linked to the Health Productivity and Management (HPM) database. Index date was defined as the first IBD claim date for IBD patients and randomly assigned for controls. Continuous enrollment for ≥12 months before and after the index date was required. Non-IBD control patients were propensity-score matched 1:1 to IBD patients based on age, sex, index year, region, and weighted Charlson Comorbidity Index. IBD-related WPL was estimated as the difference of time lost for healthcare visits (Telehealth: 2 hours; Emergency: 8 hours; Other outpatient: 4 hours; Inpatient: 8 hours/day) based on claims, and by the difference of work absence and disability days (8 hours/day) from the HPM database. IBD-related WPL cost was calculated as WPL times the 2022 average hourly compensation rate ($29.43/hour) from the Social Security Administration.

RESULTS: A total of 3305 IBD-patient-control pairs were sampled, including 464 with HPM data. The baseline characteristics were balanced after matching; the mean age of selected patients was 40.9 years. However, those with HPM data differed in several demographic measures, suggesting an inherent selection bias. IBD was associated with substantial time away from work and associated costs (CD: 57.0 hours, $1,678; UC: 37.8 hours, $1,112; P<0.001 vs non-IBD patients) per patient per year. However, the result was not significant in the HPM sub-sample.

CONCLUSIONS: IBD has a significant negative impact on patients’ work productivity, which can be costly to the employer. Precautions should be taken when using supplemental resources such as the HPM database.