bims-cieche 2025-05-18 papers

Issue of 2025–05–18
two papers selected by
Jonas Stefaan Steel, IDEWE

Front Public Health. 2025 ;13 1538789

A cost analysis of reductions in work productivity for MG patients and their caregivers by symptom severity.

Sarah Dewilde, Cynthia Z Qi, Femke De Ruyck, Sandra Paci, Lucas Van de Veire, Alison Griffiths, Gil I Wolfe, Renato Mantegazza, Glenn Phillips.

Introduction: Myasthenia Gravis (MG) is a debilitating autoimmune disorder associated with fatigue and weakness in the ocular, respiratory, bulbar and limb muscles. This study evaluates productivity losses for MG patients and their caregivers by MG symptom severity.
Methods: In the multinational MyRealWorld-MG study, 1,049 MG patients and caregivers reported on work productivity (sick leave, reduced working hours, early retirement). Productivity losses were calculated using the average wage per hour. A UK perspective was adopted for the whole sample, and country-specific analyses were conducted for Italy, Spain and the US. The MG-Activities of Daily Living (MG-ADL) score was used to estimate the association between symptom severity and productivity losses, with patients categorized as having mild (0-4), moderate (5-9), or severe (> = 10) symptoms.
Results: In the MyRealWorld-MG study, 36.5% of MG patients reported taking sick leave within the last month and 11.4% reported stopping work (or retiring early) due to MG. Furthermore, 36.0% required caregiver support with 14.6% of caregivers reducing working hours and 13.4% stopping work. Mean productivity losses were £16,630/year for patients and caregivers combined, largely attributable to patient productivity losses (£13,891). Patients with severe MG incurred 3.8 times more productivity losses compared to patients with mild disease. Productivity loss estimates varied between Italy, Spain and the US.
Conclusion: The impact of MG on patients' and caregivers' work productivity leads many of them to reduce work hours or retire early, resulting in significant productivity losses. The magnitude of these productivity losses is correlated with symptom severity and varies by country.

Keywords: ADAPT; GMG; MyRealWorld-MG; caregivers; costs; efgartigimod; generalized myasthenia gravis; productivity losses

DOI: https://doi.org/10.3389/fpubh.2025.1538789

Eur J Rheumatol. 2025 Apr 09. 12(1): 1-8

Mine Aydan Cenberoğlu, Ilhan Sezer.

Background: To examine the effect of ankylosing spondylitis (AS) on work productivity, work instability and absenteeism, and the cost to the national economy of the disease.
Methods: This cross-sectional study included 100 AS patients from the outpatient rheumatology clinic at Akdeniz University Hospital who met the 1984 modified New York criteria. Annual direct and indirect care costs of the AS patients were recorded, along with their sociodemographic data and clinical characteristics. Direct costs were based on reimbursements from the National Social Security Institution, while indirect costs were estimated using the human capital approach to account for productivity loss and absenteeism related to income, reflecting the disease's economic impact on work capabilities. The work-related outcomes were evaluated with the Work Productivity and Activity Impairment-Spondyloarthropathy (WPAI-SpA) and Ankylosing Spondylitis Work Instability Scale (AS-WIS). Pearson correlation analysis was applied to determine the relationships between quanti- tative variables, while the Chi-square test or Fisher's exact test was used for relationships between qualitative variables. To assess the effects of independent variables on work productivity impairment, activity, and work instability, multivariate linear and logistic regression methods were used.
Results: Among the 87 working AS patients, 38 (43.7%) exhibited moderate to high work instability (AS-WIS ≥ 11). These patients had higher rates of absenteeism, presenteeism, overall work impair- ment, daily activity impairment, and scores for Ankylosing Spondylitis Disease Activity Score-C Reactive Protein (ASDAS-CRP), Bath Ankylosing Spodylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), The Ankylosing Spondylitis Quality of Life, and PG-VAS. Ankylosing spondylitis patients had an average absence of 10.3 working days in the past year. Their annual healthcare costs averaged €3782.76, primarily due to medication costs of €3674.89. Among the 87 working AS patients, 10 (11%) reported productivity losses in the last year, totaling €1059.62. The AS-WIS score showed moderate to high correlations with presenteeism, daily activity impairment, overall work impairment, BASDAI, PG-VAS, BASFI, and ASDAS-CRP. In contrast, absentee- ism had weak correlations with BASMI and CRP, moderate correlation with overall work impairment, and no correlation with BASDAI and BASFI. Lateral spine mobility, quality of life, educational level, BASFI and BASMI scores, smoking, and the work performed were predictors of work instability and impairment in work productivity.
Conclusions: In addition to healthcare costs, the costs related to unemployment, absenteeism, and loss of productivity constitute a significant proportion of the total costs, and it was seen that AS has a negative effect on the economy of the country. If work instability and impairment in work productiv- ity are identified early, the risk of work disability can be reduced or eliminated with appropriate clinical and workplace interventions.

Keywords: Ankylosing spondylitis; absenteeism; cost of illness; sick leave

DOI: https://doi.org/10.5152/eurjrheum.2025.22118