PERSISTENT PRODUCTIVITY LOSS AND DISEASE ACTIVITY-RELATED INDIRECT COSTS IN INFLAMMATORY ARTHRITIS: 10-YEAR REAL-WORLD EVIDENCE FROM RHEUM4U REGISTRY
Author(s)
Ana C. Fuhrmann, PhD, Dianne P. Mosher, MD, Susanne M. Benseler, PhD, Wrechelle Ocampo, M.S., Maggie Larche, MD, Deborah A. Marshall, PhD.
University of Calgary, Calgary, AB, Canada.
University of Calgary, Calgary, AB, Canada.
OBJECTIVES: Inflammatory arthritis (IA) reduces workforce participation and productivity, yet longitudinal real-world estimates of its economic burden remain limited. This study quantified the magnitude and drivers of productivity loss and indirect costs associated with IA and evaluated the economic impact of disease activity in real-world clinical care.
METHODS: A longitudinal analysis was conducted using data from the Rheum4U Precision Health Registry (2016-2026). Employed adults aged 18-64 with IA completed the Work Productivity and Activity Impairment (WPAI) questionnaire (absenteeism, presenteeism, overall work impairment; 0-100%). Productivity losses were estimated in hours and monetized using the Human Capital Approach with 2024 Canadian age- and sex-specific wage rates. Analyses evaluated variation across disease activity, sex, and follow-up time.
RESULTS: 739 participants (2,732 observations; 64% female; median age 48 years) were included. Productivity loss remained stable over the 10 years: mean absenteeism ~5%, presenteeism ~20%, corresponding to ~22% overall work impairment, translating into 430-473 lost work hours annually and indirect costs of CAD$15,487-16,940 per participant. A consistent disease activity gradient in productivity loss and indirect costs was observed across follow-up periods, ranging from 180-252 hours in remission (CAD$4,700-9,100) to 447-640 hours in low activity (CAD$16,000-23,000), 664-741 hours in moderate activity (CAD$23,500-26,000), and 812-1057 hours in high disease activity (CAD$28,000-38,400). Women experienced greater productivity loss than men, while lower wage rates resulted in lower absolute cost estimates.
CONCLUSIONS: IA imposes substantial and persistent productivity losses that escalate with worsening disease activity and is driven largely by presenteeism. The near threefold increase in costs from remission to moderate/high disease activity highlights a major and potentially modifiable burden. Treat-to-target strategies aiming to achieve and maintain low disease activity have major societal and workforce economic implications. Accounting for wage heterogeneity and sex differences is important for accurate and equitable estimation of indirect costs in economic evaluations.
METHODS: A longitudinal analysis was conducted using data from the Rheum4U Precision Health Registry (2016-2026). Employed adults aged 18-64 with IA completed the Work Productivity and Activity Impairment (WPAI) questionnaire (absenteeism, presenteeism, overall work impairment; 0-100%). Productivity losses were estimated in hours and monetized using the Human Capital Approach with 2024 Canadian age- and sex-specific wage rates. Analyses evaluated variation across disease activity, sex, and follow-up time.
RESULTS: 739 participants (2,732 observations; 64% female; median age 48 years) were included. Productivity loss remained stable over the 10 years: mean absenteeism ~5%, presenteeism ~20%, corresponding to ~22% overall work impairment, translating into 430-473 lost work hours annually and indirect costs of CAD$15,487-16,940 per participant. A consistent disease activity gradient in productivity loss and indirect costs was observed across follow-up periods, ranging from 180-252 hours in remission (CAD$4,700-9,100) to 447-640 hours in low activity (CAD$16,000-23,000), 664-741 hours in moderate activity (CAD$23,500-26,000), and 812-1057 hours in high disease activity (CAD$28,000-38,400). Women experienced greater productivity loss than men, while lower wage rates resulted in lower absolute cost estimates.
CONCLUSIONS: IA imposes substantial and persistent productivity losses that escalate with worsening disease activity and is driven largely by presenteeism. The near threefold increase in costs from remission to moderate/high disease activity highlights a major and potentially modifiable burden. Treat-to-target strategies aiming to achieve and maintain low disease activity have major societal and workforce economic implications. Accounting for wage heterogeneity and sex differences is important for accurate and equitable estimation of indirect costs in economic evaluations.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE195
Topic
Clinical Outcomes, Economic Evaluation, Real World Data & Information Systems
Topic Subcategory
Work & Home Productivity - Indirect Costs
Disease
Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)