A Retrospective Cohort Analysis of the Impact of Osteoarthritis on Disability Leave, Worker's Compensation Claims, and Healthcare Payments
Author(s)
Thakkar S1, Gifford B2, Sell H1, Schepman P1, Robinson R3, Emir B1
1Pfizer Inc., New York, NY, USA, 2Integrated Benefits Institute, San Francisco, CA, USA, 3Eli Lilly and Company, Indianapolis, IN, USA
OBJECTIVES Examine short term disability (STD) leave, worker’s compensation (WC), and disability/healthcare payments among employees with osteoarthritis (OA) compared to other chronically painful conditions, as well as the impact of opioids in both cohorts. METHODS A retrospective observational cohort study of employees (18-64 years) eligible for STD and WC with ≥2 claims associated with OA or other pre-specified chronically painful conditions (control cohort) during 2014-2017, as defined by International Classification of Disease codes in the IBM Watson Health database. Key outcomes were lost workdays and total payments for WC/STD and healthcare payments from index (first diagnosis) to the end of the study period. Cohorts were compared using an inverse probability of treatment weighting (IPTW) approach. Outcomes were analysed using generalized linear models controlling for known confounding factors with IPTW. The models included prescription fills to examine the effect of opioids. RESULTS The most common conditions in the control cohort (n=369,211) were joint pain (50%), limb pain (45%), and back pain (37%). Average length of follow-up was around 32.5 months in both cohorts. The OA cohort (n=144,355) had, on average, 1.3 more STD days, $157 higher STD payments, and $909 higher healthcare payments than the control cohort (all p<0.001). WC days and payments were similar in both cohorts. When both cohorts were combined, absences and payments were higher (p<0.001) in employees with prior opioid prescriptions vs those without: STD (+3.6) and WC (+0.5) days, STD: (+$514); WC: (+$167), and healthcare (+$7,401) payments. CONCLUSIONS Among employees with chronic pain conditions, those who have previously used opioids have more lost workdays and higher healthcare payments than those who haven’t. Osteoarthritis is associated with increased STD days/payments compared to other chronically painful conditions. Employee healthcare benefits could focus on improvements for employees with OA and for those using opioids.
Conference/Value in Health Info
2021-05, ISPOR 2021, Montreal, Canada
Value in Health, Volume 24, Issue 5, S1 (May 2021)
Code
PMS9
Topic
Economic Evaluation
Topic Subcategory
Work & Home Productivity - Indirect Costs
Disease
Musculoskeletal Disorders