Do the Washington Panel recommendations hold for Europe: investigating the relation between quality of life versus work-status, absenteeism and presenteeism

Cost Effectiveness and Resource Allocation

Johan L Severens³  Annelies Boonen²  Saskia Knies¹ 

[1] Institute of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, the Netherlands;Department of Internal Medicine, Division of Rheumatology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Center+, Maastricht, the Netherlands;Institute of Medical Technology Assessment (iMTA), Erasmus University Rotterdam, Rotterdam, the Netherlands

关键词: Relation;    Valuation;    Productivity losses;    Quality of life;   

Others  :  1109972
DOI  :  10.1186/1478-7547-12-24

 received in 2014-06-09, accepted in 2014-11-17,  发布年份 2014

【 摘 要 】

Background

The question of how to value lost productivity in economic evaluations has been subject of debate in the past twenty years. According to the Washington panel, lost productivity influences health-related quality of life and should thus be considered a health effect instead of a cost to avoid double counting. Current empirical evidence on the inclusion of income loss when valuing health states is not decisive. We examined the relationship between three aspects of lost productivity (work-status, absenteeism and presenteeism) and patient or social valuation of health-related quality of life (HRQoL).

Methods

Cross-sectional survey data were collected from a total of 830 respondents with a rheumatic disorder from four West-European countries. Health-related quality of life was expressed in either the European societal utility using EQ-5D-3L or the patient valuation using EQ-VAS. The impact of work-status (four categories), absenteeism (absent from paid work during the past three months), and presenteeism (QQ method) on EQ-5D utilities and VAS scores was examined in linear regression analyses taking into account demographic characteristics and disease severity (duration, pain and restriction).

Results

The relationship between work-status, absenteeism or presenteeism and HRQoL was stronger for patient valuation than societal valuation. Compared to work-status and presenteeism the relationship between absenteeism and HRQoL was even less explicit. However, results for all measures of lost productivity are only marginally significant and negligible compared to the influence of disease-related restrictions.

Conclusions

This survey study in patients with a rheumatic disorder in four European countries, does not fully support the Washington panel’s claim that lost productivity is a significantly related with HRQoL, and this is even more apparent for absenteeism than for work-status and presenteeism. For West-European countries, there is no reason, to include absenteeism in the QALY. Findings need to be confirmed in other disease areas.

【 授权许可】

   
2014 Knies et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Drummond M, Barbieri M, Cook J, Glick HA, Lis J, Malik F, Reed SD, Rutten F, Sculpher M, Severens J: Transferability of economic evaluations across jurisdictions: ISPOR good research practices task force report. Value Health 2009, 12:409-418.
• [2]Barbieri M, Drummond M, Rutten F, Cook J, Glick HA, Lis J, Reed SD, Sculpher M, Severens J: What do international pharmacoeconomic guidelines say about economic data transferability? Value Health 2010, 13:1028-1037.
• [3]Byford S, Raftery J: Economic notes: perspectives in economic evaluation. BMJ 1998, 316(7143):1529-1530.
• [4]Sculpher M, Drummond MF, MacGuire A: The role and estimation of productivity costs in economic evaluation. In Economic evaluation in health care. Merging theory with practice. Oxford: Oxford University Press; 2005:94-112.
• [5]Koopmanschap M, Burdorf A, Jacob K, Meerding WJ, Brouwer W, Severens H: Measuring productivity changes in economic evaluation. Setting the research agenda. Pharmacoeconomics 2005, 23:47-54.
• [6]Van Asselt ADI, Dirksen CD, Arntz A, Severens JL: Difficulties in calculating productivity costs: work disability associated with borderline personality disorder. Value Health 2008, 11:637-644.
• [7]Gold MR, Siegel JE, Russel LB, Weinstein MC: Cost-effectiveness in health and medicine. New York: Oxford University Press; 1996.
• [8]Knies S, Severens JL, Ament AJHA, Evers SMAA: The transferability of valuing lost productivity across jurisdictions. Differences between national pharmacoeconomic guidelines. Value Health 2010, 13:519-527.
• [9]Davidson T, Levin LA: Do individuals consider expected income when valuing health states? Int J Technol Assess Health Care 2008, 24:488-494.
• [10]Siegel JE, Torrance GW, Russell LB, Luce BR, Weinstein MC, Gold MR: Guidelines for pharmacoeconomic studies: Recommendations from the Panel on Cost Effectiveness in Health and Medicine. Pharmacoeconomics 1997, 11:159-168.
• [11]Brouwer WBF, Koopmanschap MA, Rutten FFH: Productivity costs in cost-effectiveness analysis: numerator or denominator: a further discussion. Health Econ 1997, 6:511-514.
• [12]Brouwer WBF, Meerding WJ, Lamers LM, Severens JL: The relationship between productivity and health-related QOL: an exploration. Pharmacoeconomics 2005, 23:209-218.
• [13]Knies S, Candel MJJM, Boonen A, Evers SMAA, Ament AJHA, Severens JL: Lost productivity in four European countries among patients with rheumatic disorders: Are absenteeism and presenteeism transferable? Pharmacoeconomics 2012, 30:795-807.
• [14]Szende A, Oppe M, Devlin N: EQ-5D value sets: Inventory, comparative review and user guide. Dordrecht: Springer; 2007.
• [15]Koopmanschap MA: PRODISQ: a modular questionnaire on productivity and disease for economic evaluation studies. Expert Rev Pharmacoecon Outcomes Res 2005, 5:23-28.
• [16]Koopmanschap MA, Meerding WJ, Evers SMAA, Severens J, Burdorf A, Brouwer W: (PROductivity and DISease Questionnaire (PRODISQ); Een modulaire vragenlijst over de relatie tussen ziekte en productiviteitskosten, Toepasbaar bij economische evaluaties van gezondheidszorgprogramma’s voor patiënten en werknemers. In Instituut voor Medical Technology Assessment, Erasmus Universiteit Rotterdam/Instituut Maatschappelijke Gezondheidszorg, Erasmus Medisch Centrum/Beleid Economie en Organisatie van de Zorg. Rotterdam/Maastricht: Universiteit Maastricht; 2004.
• [17]Riemsma RP, Taal E, Rasker JJ, Houtman PM, Van Paassen HC, Wiegman O: Evaluation of a Dutch version of the AIMS2 for patients with rheumatoid arthritis. Brit J Rheumatol 1996, 35:755-760.
• [18]Tilling C, Krol M, Tsuchiya A, Brazier J, Brouwer W: In or out? Income losses in health state valuations: a review. Value Health 2010, 13:298-305.
• [19]Shiroiwa T, Fukuda T, Ikeda S, Shimuzoma K: QALY and productivity loss: empirical evidence for “double counting”. Value Health 2013, 16:581-587.
• [20]Krol M, Stolk E, Brouwer W: Predicting productivity based on EQ-5D: an explorative study. Eur J Health Econ 2014, 15:465-475.