OBJECTIVES: Patients with BM frequently experience SREs including pathological fracture, surgery or radiation to bone, or spinal cord compression .The study objective was to estimate STD (work hour loss) and associated costs in patients with SREs in a population with BM secondary to solid tumors. METHODS: Patients with diagnosis of solid tumors and BM were extracted from MarketScan® Health Productivity and Management Database and Commercial Database in 2002-2010. Eligible patients were 18-64 year-old full-time employees, had STD benefit eligibility, and had ≥6 months continuous pre-index enrollment (pre-period) and ≥1 month follow-up.  For SRE patients, index date was the first SRE claim. For patients without SREs, index date was assigned per the distribution of index dates from SRE patients.  Monthly STD hours and costs associated with STD were estimated during the first (up to) 6 months and the first (up to) 12 months.  Generalized linear models estimated the marginal impact of having SRE on STD hours and associated costs, controlling for baseline STD hours and patients’ characteristics. RESULTS: A total of 854 patients with SREs and 701 patients without SREs were included, with a mean age of 52.1 and 51.6 years, respectively.  52.2% of SRE patients reported STD during the 6-month follow-up, compared with 19.1% of patients without SREs. For SRE patients, the mean STD hours were 21.2 per month in pre-period and 61.3 during follow-up. The hours for patients without SREs were 8.6 and 14.4, respectively. Multivariate analysis indicated that SREs were associated with significantly increased STD hours (39.4 per month) and associated costs ($613 per month) during the 6-month follow-up period. Results from the 12-month follow-up period were similar. CONCLUSIONS:  SREs were associated with significantly increased STD hours and associated costs. Therapies that prevent or delay the development of SREs may reduce work loss and costs associated with it.