OBJECTIVES:  Assessment of lost productivity through health-related productivity instruments (HRPIs) is useful for pharmacoeconomic research. The aim of this study was to conduct a systematic review and critique of HRPIs. METHODS:  Through a comprehensive search in the PubMed database using the keywords “health-related productivity,” “absenteeism,” and “presenteeism,” the following generic, validated HRPIs were found: American Productivity Audit and Work Health Interview (APA&WHI), Endicott Work Productivity Scale (EWPS), Health and Labor Questionnaire (HLQ), Health and Work Performance Questionnaire (HPQ), Health and Work Questionnaire (HWQ), Health-Related Productivity Questionnaire-Diary (HRPQ-D), Stanford Presenteeism Scale (SPS), Work Limitations Questionnaire (WLQ), Work Productivity and Activity Impairment (WPAI), Work Productivity Short Inventory (WPSI), and Worker Productivity Index (WPI). All HRPIs were graded on five major and three minor assessment criteria. Major criteria included (1) lost productivity could be attributed to a specific health-problem; (2) presenteeism was measured; (3) absenteeism was measured; (4) lost productivity was expressed in hours lost; and (5) productivity could be measured for both those in and out of the labor force. Minor criteria included (1) how perceived impairment was measured; (2) the minimum recall period required; and (3) whether population norms existed or could be obtained. RESULTS: All of the HRPIs except HRPQ-D failed to provide information on at least one major criterion. The SPS, WLQ, WPAI and WPSI lacked information on 1 major criterion, APA&WHI, HLQ and HPQ on 2 major criteria, EWPS on 3 major criteria and HWQ on 4 major criteria. The HRPQ-D, SPS, WLQ, WPAI and WPSI satisfied all or at least 1 major criterion but lacked 1-3 minor criteria. The common major criterion frequently lacking among the SPS, WLQ, WPAI and WPSI was either household-related productivity loss or valuation. CONCLUSIONS: Current HRPIs lack comprehensive estimation of lost productivity.  There is an opportunity to develop stronger survey instruments.