SOCIETAL BURDEN OF ISCHAEMIC STROKE: A NATIONWIDE COHORT STUDY IN SWEDEN
Author(s)
Amélie Beaudet, MSc, PharmD1, Kelsi Alexandra Smith, PhD2, Jonas Banefelt, MSc2, Michael Hurst, BSc, MSc3, Andrius Kavaliunas, BSc, MPH, PhD4, Raphaela Mayerhofer, PhD2, Timothy Ming, MSc5, Gillian Murphy, MsC2, Nadia Pillai, PhD6, Patrik Sandin, PhD2, Meghan Thompson, PharmD7, Katarina Jood, Professor8.
1Director, Global Market Access, Johnson & Johnson, Allschwill, Switzerland, 2Quantify Research, Stockholm, Sweden, 3Bristol Myers Squibb, Uxbridge, United Kingdom, 4Johnson & Johnson, Solna, Sweden, 5Janssen-Cilag, High Wycombe, United Kingdom, 6J&J, Allschwil, Switzerland, 7Johnson & Johnson, Raritan, NJ, USA, 8University of Gothenburg, Gothenburg, Sweden.
1Director, Global Market Access, Johnson & Johnson, Allschwill, Switzerland, 2Quantify Research, Stockholm, Sweden, 3Bristol Myers Squibb, Uxbridge, United Kingdom, 4Johnson & Johnson, Solna, Sweden, 5Janssen-Cilag, High Wycombe, United Kingdom, 6J&J, Allschwil, Switzerland, 7Johnson & Johnson, Raritan, NJ, USA, 8University of Gothenburg, Gothenburg, Sweden.
OBJECTIVES: Ischaemic stroke (IS) is a leading cause of long-term disability. This study aimed to quantify long-term productivity loss in working-age patients with non-cardioembolic IS eligible for antiplatelet secondary prevention.
METHODS: Linked nationwide Swedish registers of inpatient and outpatient hospital care were used to identify patients experiencing an IS between 2013 and 2023. The index date was the outpatient visit or hospital discharge date of the first IS event. Exclusion criteria were prior IS and atrial fibrillation (12 years pre-index), active cancer and anticoagulant use (1 year), migration (5 years), or in-hospital death. Working-age patients (18-65 years) were matched with controls (1:5) by age, sex, and region. Productivity loss (sickness absence >14 days or disability pension), reported as median and mean full-day equivalents (FDE) for all-cause and cardiovascular (CV)-related causes, was calculated annually for 5 years pre- and post-index (10 year study period). Analyses were stratified by sex.
RESULTS: Analyses included 18,373 working-age patients matched to 89,266 controls. Median all-cause productivity loss was 0 FDE in patients and controls through most of the pre-index period (mean range: 54.5-60.4 vs 37.2-40.7, respectively). Following index, median FDE loss rose sharply in patients, peaking at 1 year (median: 154.5 vs 0 in controls; mean: 176.1 vs 38.8) and declining to 0 by 3 years (mean: 113.9 vs 38.3). This transient increase was driven by sickness absence, with disability pension staying relatively stable throughout the study period. A similar trend was observed for CV-related causes. All-cause productivity loss was higher in women than men (1-year post-index: median, 207.8 vs 126.0 FDE; mean: 198.8 vs 163.5 FDE), whereas CV-related loss was modestly higher in men by median but comparable by mean.
CONCLUSIONS: IS imposes a substantial burden on working-age patients, with all-cause productivity loss notably higher in women. Effective strategies are needed to reduce stroke incidence and post-event disability.
METHODS: Linked nationwide Swedish registers of inpatient and outpatient hospital care were used to identify patients experiencing an IS between 2013 and 2023. The index date was the outpatient visit or hospital discharge date of the first IS event. Exclusion criteria were prior IS and atrial fibrillation (12 years pre-index), active cancer and anticoagulant use (1 year), migration (5 years), or in-hospital death. Working-age patients (18-65 years) were matched with controls (1:5) by age, sex, and region. Productivity loss (sickness absence >14 days or disability pension), reported as median and mean full-day equivalents (FDE) for all-cause and cardiovascular (CV)-related causes, was calculated annually for 5 years pre- and post-index (10 year study period). Analyses were stratified by sex.
RESULTS: Analyses included 18,373 working-age patients matched to 89,266 controls. Median all-cause productivity loss was 0 FDE in patients and controls through most of the pre-index period (mean range: 54.5-60.4 vs 37.2-40.7, respectively). Following index, median FDE loss rose sharply in patients, peaking at 1 year (median: 154.5 vs 0 in controls; mean: 176.1 vs 38.8) and declining to 0 by 3 years (mean: 113.9 vs 38.3). This transient increase was driven by sickness absence, with disability pension staying relatively stable throughout the study period. A similar trend was observed for CV-related causes. All-cause productivity loss was higher in women than men (1-year post-index: median, 207.8 vs 126.0 FDE; mean: 198.8 vs 163.5 FDE), whereas CV-related loss was modestly higher in men by median but comparable by mean.
CONCLUSIONS: IS imposes a substantial burden on working-age patients, with all-cause productivity loss notably higher in women. Effective strategies are needed to reduce stroke incidence and post-event disability.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE614
Topic
Economic Evaluation
Topic Subcategory
Work & Home Productivity - Indirect Costs
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)