Costs of Workplace Productivity Loss in Patients With Fibrotic Interstitial Lung Disease

Abstract

BACKGROUND: Fibrotic interstitial lung diseases (ILDs) are highly morbid chronic disorders that frequently occur in working age individuals. The goal of this study was to determine workplace productivity loss, its determinants, and its estimated costs in patients with fibrotic ILD. METHODS: Patients with idiopathic pulmonary fibrosis, chronic hypersensitivity pneumonitis, idiopathic nonspecific interstitial pneumonia, or unclassifiable ILD were identified from the six-center Canadian Registry for Pulmonary Fibrosis (CARE-PF). The Work Productivity and Activity Impairment questionnaire was used to determine health-related productivity loss. Independent predictors of low workplace productivity were identified by using multivariate regression. Patient data were compared with Canadian population census data. The average productivity loss (hours per week) and the individual's hourly wage were used to estimate the costs of productivity loss. RESULTS: Of 650 eligible patients, 148 (23%) were employed. Productivity loss was reported by 55% of employed patients with an average productivity loss of 7.8 AE 0.9 h per week (2.3 AE 0.6 h per week related to absenteeism and 5.5 AE 0.6 h per week related to presenteeism). Employment among patients with ILD aged 25 to 54 years was 23% lower than the age-and sex-matched general Canadian population (60% vs 83%; P < .001). Employment among ABBREVIATIONS: CAD = Canadian dollar; CARE-PF = Canadian Registry for Pulmonary Fibrosis; DLCO = diffusing capacity of the lung for carbon monoxide; ILD = interstitial lung disease; IPF = idiopathic pulmonary fibrosis; VAS = visual analog scale; WPAI = work productivity and activity impairment

Soldiering on the Job When Ill: Productivity Costs in Connective Tissue Disease–associated Interstitial Lung Disease

“…Similar to the findings in patients with non-CTD FILD ( 6 ), productivity loss in patients with CTD-FILD assessed by the Work Productivity and Activity Impairment (WPAI) questionnaire was reported by 59% of employed patients. The analysis demonstrated a substantially more important role of percent productivity loss, hours lost, and cost resulting from presenteeism (51% or 5.5 ± 0.7 hours lost per week or an average annual cost of 7,876 CAD per patient) compared with that driven by absenteeism (24% or 3.9 ± 0.9 hours lost per week or an average annual cost of 5,717 CAD per patient).…”

“…However, the often much costlier counterpart of absenteeism and the less visible contributor to workplace productivity loss is presenteeism—being on the job, but because of illness, not fully functioning. Indeed, a recent study by Algamdi and colleagues using data from a six-center Canadian Registry for Pulmonary Fibrosis (CARE-PF) showed that among 650 patients with idiopathic fibrotic ILD (FILD), chronic hypersensitivity pneumonitis, and unclassifiable FILD, only 148 (23%) were employed ( 6 ). Productivity loss was reported by 55% of employed patients, with absenteeism affecting 14% and presenteeism affecting 52% of patients.…”

A 2019 Update on Occupational Lung Diseases: A Narrative Review

“…Algamdi et al [ 23 ] similarly looked at the economic impact of fibrotic interstitial lung diseases (ILDs), including workplace productivity loss and the associated costs. The researchers used the Work Productivity and Activity Impairment questionnaire in patients in the six-center Canadian Registry for Pulmonary Fibrosis (CARE-PF) and compared them to Canadian population census data.…”

“…An average productivity loss of 7.8 ± 0.9 h per week was found. Presenteeism accounted for the majority of this loss (5.5 ± 0.6 h per week), while absenteeism accounted for a smaller proportion (2.3 ± 0.6 h per week) [ 23 ]. This study demonstrates the significant economic impact of fibrotic interstitial lung diseases.…”

A systematic review on the economic burden of interstitial lung disease and the cost-effectiveness of current therapies

“…The cost components used to determine indirect costs was variable. Two Canadian studies specifically focused on work productivity loss in fibrotic ILD (Table 1 ) [ 16 , 17 ]. Productivity loss associated with absenteeism and presenteeism refers to loss as a result of absence from work and working with limitations due to illness, respectively [ 18 ].…”