Abstract
Background
Productivity costs are often ignored in economic evaluations. In order to facilitate productivity cost inclusion, it has been suggested to estimate productivity costs indirectly using quality of life data.
Objective
This study aimed to derive and validate an algorithm for predicting productivity losses on the basis of quality-of-life data using the EQ-5D-3L.
Methods
A large representative sample of the Dutch general public (n = 1,100) was asked in a web-based questionnaire to state their expected level of productivity in terms of absenteeism and presenteeism for multiple EQ-5D health states. Based on these data, two generalized estimating equations (GEE) models were constructed: (1) a model predicting levels of absenteeism and (2) a model predicting presenteeism. The models were validated by comparing model predictions with conventionally measured productivity within a group of low back pain patients.
Results
Predicted absenteeism levels based on EQ-5D health state closely resembled conventionally measured absenteeism levels. Productivity losses related to presenteeism seemed somewhat overestimated by our prediction model. Measured and predicted productivity were moderately but highly significantly correlated.
Conclusions
Overall, it appears possible to make reasonable productivity predictions based on EQ-5D data. Further exploration and validation of prediction algorithms remains necessary, however, especially for presenteeism.
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References
Claxton, K., Walker, S., Palmer, S., Sculpher, M.: Appropriate Perspectives for Health Care Decisions. CHE 2010; CHE Research paper 54 (2010)
Gold, M., Siegel, J., Russell, L., Weinstein, M.: Cost-Effectiveness in Health and Medicine. Oxford University Press, Oxford (1996)
Jonsson, B.: Ten arguments for a societal perspective in the economic evaluation of medical innovations. Eur. J. Health Econ. 10, 357–359 (2009)
Brouwer, W.B., Koopmanschap, M.A., Rutten, F.F.: Productivity costs in cost-effectiveness analysis: numerator or denominator: a further discussion. Health Econ. 6, 511–514 (1997)
Stone, P.W., Chapman, R.H., Sandberg, E.A., et al.: Measuring costs in cost-utility analyses. Variations in the literature. Int. J. Technol. Assess. Health Care 16, 111–124 (2000)
Krol, M., Papenburg, J., Koopmanschap, M., Brouwer, W.: Do productivity costs matter? The impact of including productivity costs on the incremental costs of interventions targeted at depressive disorders. Pharmacoeconomics 29, 601–619 (2011)
Koopmanschap, M.A., Rutten, F.F.: The impact of indirect costs on outcomes of health care programs. Health Econ. 3, 385–393 (1994)
Lindholm, L., Lofroth, E., Rosen, M.: Does productivity influence priority setting? A case study from the field of CVD prevention. Cost Eff. Resour. Alloc. 6, 6 (2008)
Williams, A.: Cost-effectiveness analysis: is it ethical? J. Med. Ethics 18, 7–11 (1992)
Tranmer, J.E., Guerriere, D.N., Ungar, W.J., Coyte, P.C.: Valuing patient and caregiver time: a review of the literature. Pharmacoeconomics 23, 449–459 (2005)
Koopmanschap, M., Burdorf, A., Jacob, K., et al.: Measuring productivity changes in economic evaluation: setting the research agenda. Pharmacoeconomics 23, 47–54 (2005)
Knies, S., Severens, J.L., Ament, A.J., Evers, S.M.: The transferability of valuing lost productivity across jurisdictions. Differences between national pharmacoeconomic guidelines. Value Health 13, 519–527 (2010)
Brouwer, W.B., Meerding, W.J., Lamers, L.M., Severens, J.L.: The relationship between productivity and health-related QOL: an exploration. Pharmacoeconomics 23, 209–218 (2005)
Lamers, L.M., Meerding, W.J., Severens, J.L., Brouwer, W.B.: The relationship between productivity and health-related quality of life: an empirical exploration in persons with low back pain. Qual. Life Res. 14, 805–813 (2005)
Johannesson, M., Meltzer, D., O’Conor, R.M.: Incorporating future costs in medical cost-effectiveness analysis: implications for the cost-effectiveness of the treatment of hypertension. Med. Decis. Making 17, 382–389 (1997)
Rabin. R., de Charro, F.: EQ-5D: a measure of health status from the EuroQol Group. Ann. Med. 33, 3373–3343 (2001)
Brouwer, W.B., Koopmanschap, M.A., Rutten, F.F.: Productivity losses without absence: measurement validation and empirical evidence. Health Policy 48, 13–27 (1999)
Sloane, N.J.A.: A Library of Orthogonal Arrays; 2011 Available from: http://www2.research.att.com/~njas/oadir/. Accessed June 30, 2011
Dolan, P., Gudex, C., Kind, P., Williams, A.: The time trade-off method: results from a general population study. Health Econ. 5, 141–154 (1996)
van Roijen, L., Essink-Bot, M.L., Koopmanschap, M.A., et al.: Labor and health status in economic evaluation of health care. The health and labor questionnaire. Int. J. Technol. Assess. Health Care 12, 405–415 (1996)
Bekkering, G.E., van Tulder, M.W., Hendriks, E.J., et al.: Implementation of clinical guidelines on physical therapy for patients with low back pain: randomized trial comparing patient outcomes after a standard and active implementation strategy. Phys. Ther. 85, 544–555 (2005)
Hoeijenbos, M., Bekkering, T., Lamers, L., et al.: Cost-effectiveness of an active implementation strategy for the Dutch physiotherapy guideline for low back pain. Health Policy 75, 85–98 (2005)
Torrance, G.W., Feeny, D., Furlong, W.: Visual analog scales: do they have a role in the measurement of preferences for health states? Med. Decis. Making 21, 329–334 (2001)
Brazier, J., Roberts, J., Tsuchiya, A., Busschbach, J.: A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ. 13(9), 873–884 (2004)
Janssen, M.F., Birnie, E., Haagsma, J.A., Bonsel, G.J.: Comparing the standard EQ-5D three-level system with a five-level version. Value Health 11(2), 275–284 (2008)
Krabbe, P.F., Tromp, N., Ruers, T.J., van Riel, P.L.: Are patients’ judgments of health status really different from the general population? Health Qual. Life Outcomes 9, 31 (2011)
Zhang, W., Gignac, M.A., Beaton, D., et al.: Productivity loss due to presenteeism among patients with arthritis: estimates from 4 instruments. J. Rheumatol. 37, 1805–1814 (2010)
Weisbrod, B.A.: The valuation of human capital. JPE 69, 425–436 (1961)
Koopmanschap, M.A., van Ineveld, B.M.: Towards a new approach for estimating indirect costs of disease. Soc. Sci. Med. 34, 1005–1010 (1992)
Acknowledgments
We are grateful to Lucas Goossens and Mark Oppe for their useful comments in conducting this study.
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Krol, M., Stolk, E. & Brouwer, W. Predicting productivity based on EQ-5D: an explorative study. Eur J Health Econ 15, 465–475 (2014). https://doi.org/10.1007/s10198-013-0487-y
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DOI: https://doi.org/10.1007/s10198-013-0487-y