OBJECTIVES : Productivity loss can have a major impact on total costs in health economic evaluations. However, not all instruments measuring productivity loss might be suitable for use in these evaluations. The aim of this study was to perform a systematic literature review of measurement instruments of productivity loss of paid and unpaid work and to design an appraisal framework to assess the content validity and suitability in terms of availability, feasibility, and applicability of these instruments for the in economic evaluations from a societal perspective.

METHODS : Papers were sourced from PubMed/Medline, PsycInfo, Embase, and Econlit, to identify eligible economic evaluations and validation studies by two researchers independently. Unique measurement instruments were identified from the included studies. An appraisal framework was developed studying previous literature and consulting an international panel of experts in the field of productivity costs. This was applied to assess the identified instruments on their content validity and suitability for use in economic evaluations from a societal perspective.

RESULTS : In total, 5,982 articles were retrieved from the databases of which 99 economic evaluations and nine validation studies were included. From these studies, 42 unique measurement instruments were identified. Eight instruments provided quantified measures of absenteeism, presenteeism, and unpaid work. When considering the use of common valuation methods, three instruments remained, of which one was still available, the iPCQ.

CONCLUSIONS : Although many instruments for measuring productivity loss were identified, most were not suitable for use in economic evaluations from a societal perspective. Future research should focus on promoting the comparability and transferability of the measurement of productivity loss of paid and unpaid work within and across countries.