OBJECTIVES: Productivity loss constitutes a substantial proportion of indirect costs in many health conditions. For chronic conditions, such as MS, productivity decrements and associated indirect costs may increase with disease progression; however, trajectories of symptom burden, absenteeism/presenteeism, and costs are not fully characterized. Several instruments are available to assess productivity in MS and can be used to capture societal costs for economic modelling and subsequent HTA. We explored the frequency and manner in which such measures are employed in clinical studies and models.

METHODS: We conducted a review of trials in MS including productivity measures on clinicaltrials.gov and cross-referenced publicly available HTA assessment reports from NICE (UK) and TLV (Sweden).

RESULTS: Results: Overall, 15 out of 37 trials including productivity were interventional, with cladribine, dimethyl fumuarate, ocrelizumab, and natalizumab the most common interventions. Ten studies were either phase 4 (n=7) or phase 3 (n=3). Among reported instruments, WPAI:MS (n=11) was used most often, followed by other forms of WPAI (either WPAI, WPAI: general health, or WPAI: specific health problem; n=11). The percentage of trials including productivity was low overall, but Nordic countries had higher rates than the UK. As expected, in all seven applicable assessment reports identified from NICE, productivity did not inform the economic model. Publicly available assessments from TLV, which considers the societal perspective, were scarce. An assessment of ocrelizumab reported uncertainty in the representativeness of published work-absence data in the model; however, inclusion of indirect costs had a major impact on the results in some comparisons.

CONCLUSIONS: Productivity measures may be valuable to inform representative economic modelling in geographies that consider the societal perspective and can impact results; however, current use, and consideration and acceptance by HTA bodies is variable.