Work disability and productivity loss in patients with inflammatory bowel diseases in Hungary in the era of biologics

Mandel D. Michael, Anita Bálint, Barbara D. Lovász, L. Gulácsi, Bálint Strbák, Petra A. Golovics, Klaudia Farkas, Zsuzsanna Kürti, Blanka K. Szilágyi, Anna Mohás, T. Molnár, P. Lakatos

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Abstract

Background and aims: To assess work disability (WD) rates in an inflammatory bowel disease (IBD) cohort involving patients with Crohn's disease (CD) or ulcerative colitis (UC) cohort and to identify possible clinical or demographic factors associated with WD. To our knowledge, this is the first study from Eastern Europe that has estimated indirect costs in IBD. Methods: Data from 443 (M/F: 202/241, CD/UC: 260/183, mean age: 35.5 (CD) and 40.5 (UC) years, biological drug exposure 31.2/11.5%) consecutive patients were included. WD data were collected by questionnaire and the work productivity and activity impairment instrument. Disability pension (DP) rates in the general population were retrieved from public databases. Results: The overall DP rate in this IBD population was 32.3%, with partial disability in 24.2%. Of all DP events, 88.8% were directly related to IBD. Overall, full DP was more prevalent in IBD (RR: 1.51, p <0.001) and CD (RR: 1.74, p <0.001) but not in UC compared to the general population and also in CD compared to UC (OR 1.57, p = 0.03). RR for full DP was increased only in young CD patients (RR: 9.4; RR36-40 year olds: 9.4 and 5.6, p <0.01 for both). In CD, age group, previous surgery, disease duration, frequent relapses, and the presence of arthritis/arthralgia were associated with an increased risk for DP. Among employed patients, absenteeism and presenteeism was reported in of 25.9 and 60.3% patients, respectively, leading to a 28% loss of work productivity and a 32% activity loss, and was associated with disease activity and age group. Average cost of productivity loss due to disability and sick leave with a human capital approach was 1,450 and 430 €/patient/year in IBD, respectively (total productivity loss 1,880 €/patient/year), the costs of presenteeism were 2,605 (SD = 2,770) and 2,410 (SD = 2,970) €/patient/year in CD and UC, respectively. Conclusion: Risk of DP was highly increased in young CD patients (sixfold to ninefold). Previous surgery and presence of arthritis/arthralgia was identified as risk factors for DP. Work productivity is significantly impaired in IBD and is associated with high productivity loss.

Original languageEnglish
JournalEuropean Journal of Health Economics
Volume15
Issue numberSUPPL. 1
DOIs
Publication statusPublished - 2014

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Hungary
Pensions
Biological Products
Inflammatory Bowel Diseases
Crohn Disease
Ulcerative Colitis
Efficiency
Sick Leave
Arthralgia
Costs and Cost Analysis
Arthritis
Age Groups
Population
Productivity
Eastern Europe
Absenteeism
Economics
Demography
Databases
Recurrence

Keywords

  • Anti-TNF
  • CD
  • Hungary
  • Productivity loss
  • UC
  • Work disability

ASJC Scopus subject areas

  • Health Policy
  • Economics, Econometrics and Finance (miscellaneous)
  • Medicine(all)

Cite this

Work disability and productivity loss in patients with inflammatory bowel diseases in Hungary in the era of biologics. / Michael, Mandel D.; Bálint, Anita; Lovász, Barbara D.; Gulácsi, L.; Strbák, Bálint; Golovics, Petra A.; Farkas, Klaudia; Kürti, Zsuzsanna; Szilágyi, Blanka K.; Mohás, Anna; Molnár, T.; Lakatos, P.

In: European Journal of Health Economics, Vol. 15, No. SUPPL. 1, 2014.

Research output: Contribution to journalArticle

Michael, Mandel D. ; Bálint, Anita ; Lovász, Barbara D. ; Gulácsi, L. ; Strbák, Bálint ; Golovics, Petra A. ; Farkas, Klaudia ; Kürti, Zsuzsanna ; Szilágyi, Blanka K. ; Mohás, Anna ; Molnár, T. ; Lakatos, P. / Work disability and productivity loss in patients with inflammatory bowel diseases in Hungary in the era of biologics. In: European Journal of Health Economics. 2014 ; Vol. 15, No. SUPPL. 1.
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abstract = "Background and aims: To assess work disability (WD) rates in an inflammatory bowel disease (IBD) cohort involving patients with Crohn's disease (CD) or ulcerative colitis (UC) cohort and to identify possible clinical or demographic factors associated with WD. To our knowledge, this is the first study from Eastern Europe that has estimated indirect costs in IBD. Methods: Data from 443 (M/F: 202/241, CD/UC: 260/183, mean age: 35.5 (CD) and 40.5 (UC) years, biological drug exposure 31.2/11.5{\%}) consecutive patients were included. WD data were collected by questionnaire and the work productivity and activity impairment instrument. Disability pension (DP) rates in the general population were retrieved from public databases. Results: The overall DP rate in this IBD population was 32.3{\%}, with partial disability in 24.2{\%}. Of all DP events, 88.8{\%} were directly related to IBD. Overall, full DP was more prevalent in IBD (RR: 1.51, p <0.001) and CD (RR: 1.74, p <0.001) but not in UC compared to the general population and also in CD compared to UC (OR 1.57, p = 0.03). RR for full DP was increased only in young CD patients (RR: 9.4; RR36-40 year olds: 9.4 and 5.6, p <0.01 for both). In CD, age group, previous surgery, disease duration, frequent relapses, and the presence of arthritis/arthralgia were associated with an increased risk for DP. Among employed patients, absenteeism and presenteeism was reported in of 25.9 and 60.3{\%} patients, respectively, leading to a 28{\%} loss of work productivity and a 32{\%} activity loss, and was associated with disease activity and age group. Average cost of productivity loss due to disability and sick leave with a human capital approach was 1,450 and 430 €/patient/year in IBD, respectively (total productivity loss 1,880 €/patient/year), the costs of presenteeism were 2,605 (SD = 2,770) and 2,410 (SD = 2,970) €/patient/year in CD and UC, respectively. Conclusion: Risk of DP was highly increased in young CD patients (sixfold to ninefold). Previous surgery and presence of arthritis/arthralgia was identified as risk factors for DP. Work productivity is significantly impaired in IBD and is associated with high productivity loss.",
keywords = "Anti-TNF, CD, Hungary, Productivity loss, UC, Work disability",
author = "Michael, {Mandel D.} and Anita B{\'a}lint and Lov{\'a}sz, {Barbara D.} and L. Gul{\'a}csi and B{\'a}lint Strb{\'a}k and Golovics, {Petra A.} and Klaudia Farkas and Zsuzsanna K{\"u}rti and Szil{\'a}gyi, {Blanka K.} and Anna Moh{\'a}s and T. Moln{\'a}r and P. Lakatos",
year = "2014",
doi = "10.1007/s10198-014-0603-7",
language = "English",
volume = "15",
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number = "SUPPL. 1",

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TY - JOUR

T1 - Work disability and productivity loss in patients with inflammatory bowel diseases in Hungary in the era of biologics

AU - Michael, Mandel D.

AU - Bálint, Anita

AU - Lovász, Barbara D.

AU - Gulácsi, L.

AU - Strbák, Bálint

AU - Golovics, Petra A.

AU - Farkas, Klaudia

AU - Kürti, Zsuzsanna

AU - Szilágyi, Blanka K.

AU - Mohás, Anna

AU - Molnár, T.

AU - Lakatos, P.

PY - 2014

Y1 - 2014

N2 - Background and aims: To assess work disability (WD) rates in an inflammatory bowel disease (IBD) cohort involving patients with Crohn's disease (CD) or ulcerative colitis (UC) cohort and to identify possible clinical or demographic factors associated with WD. To our knowledge, this is the first study from Eastern Europe that has estimated indirect costs in IBD. Methods: Data from 443 (M/F: 202/241, CD/UC: 260/183, mean age: 35.5 (CD) and 40.5 (UC) years, biological drug exposure 31.2/11.5%) consecutive patients were included. WD data were collected by questionnaire and the work productivity and activity impairment instrument. Disability pension (DP) rates in the general population were retrieved from public databases. Results: The overall DP rate in this IBD population was 32.3%, with partial disability in 24.2%. Of all DP events, 88.8% were directly related to IBD. Overall, full DP was more prevalent in IBD (RR: 1.51, p <0.001) and CD (RR: 1.74, p <0.001) but not in UC compared to the general population and also in CD compared to UC (OR 1.57, p = 0.03). RR for full DP was increased only in young CD patients (RR: 9.4; RR36-40 year olds: 9.4 and 5.6, p <0.01 for both). In CD, age group, previous surgery, disease duration, frequent relapses, and the presence of arthritis/arthralgia were associated with an increased risk for DP. Among employed patients, absenteeism and presenteeism was reported in of 25.9 and 60.3% patients, respectively, leading to a 28% loss of work productivity and a 32% activity loss, and was associated with disease activity and age group. Average cost of productivity loss due to disability and sick leave with a human capital approach was 1,450 and 430 €/patient/year in IBD, respectively (total productivity loss 1,880 €/patient/year), the costs of presenteeism were 2,605 (SD = 2,770) and 2,410 (SD = 2,970) €/patient/year in CD and UC, respectively. Conclusion: Risk of DP was highly increased in young CD patients (sixfold to ninefold). Previous surgery and presence of arthritis/arthralgia was identified as risk factors for DP. Work productivity is significantly impaired in IBD and is associated with high productivity loss.

AB - Background and aims: To assess work disability (WD) rates in an inflammatory bowel disease (IBD) cohort involving patients with Crohn's disease (CD) or ulcerative colitis (UC) cohort and to identify possible clinical or demographic factors associated with WD. To our knowledge, this is the first study from Eastern Europe that has estimated indirect costs in IBD. Methods: Data from 443 (M/F: 202/241, CD/UC: 260/183, mean age: 35.5 (CD) and 40.5 (UC) years, biological drug exposure 31.2/11.5%) consecutive patients were included. WD data were collected by questionnaire and the work productivity and activity impairment instrument. Disability pension (DP) rates in the general population were retrieved from public databases. Results: The overall DP rate in this IBD population was 32.3%, with partial disability in 24.2%. Of all DP events, 88.8% were directly related to IBD. Overall, full DP was more prevalent in IBD (RR: 1.51, p <0.001) and CD (RR: 1.74, p <0.001) but not in UC compared to the general population and also in CD compared to UC (OR 1.57, p = 0.03). RR for full DP was increased only in young CD patients (RR: 9.4; RR36-40 year olds: 9.4 and 5.6, p <0.01 for both). In CD, age group, previous surgery, disease duration, frequent relapses, and the presence of arthritis/arthralgia were associated with an increased risk for DP. Among employed patients, absenteeism and presenteeism was reported in of 25.9 and 60.3% patients, respectively, leading to a 28% loss of work productivity and a 32% activity loss, and was associated with disease activity and age group. Average cost of productivity loss due to disability and sick leave with a human capital approach was 1,450 and 430 €/patient/year in IBD, respectively (total productivity loss 1,880 €/patient/year), the costs of presenteeism were 2,605 (SD = 2,770) and 2,410 (SD = 2,970) €/patient/year in CD and UC, respectively. Conclusion: Risk of DP was highly increased in young CD patients (sixfold to ninefold). Previous surgery and presence of arthritis/arthralgia was identified as risk factors for DP. Work productivity is significantly impaired in IBD and is associated with high productivity loss.

KW - Anti-TNF

KW - CD

KW - Hungary

KW - Productivity loss

KW - UC

KW - Work disability

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