Nathan L. Kleinman

Cost of gastro-oesophageal reflux disease to the employer: a perspective from the United States.

Employers pay more than just salary for their employees. Previous studies have largely focused on direct medical and prescription drug costs of gastro‐oesophageal reflux disease (GERD), and few have reported on total absenteeism costs.

Burden of fibromyalgia and comparisons with osteoarthritis in the workforce.

Objectives: To calculate the fibromyalgia (FM) burden of illness (BOI) from the employer perspective and to compare annual prevalence, work output, absence, and health benefit costs of employees with FM versus osteoarthritis (OA). Methods: Retrospective regression model analysis comparing objective work output, total health benefit (health care, prescription drug, sick leave, disability, workers’ compensation) costs, and absence days for FM, versus OA and NoFM cohorts, while controlling for differences in patient characteristics. Results: FM prevalence was 0.73%; OA 0.90%. Total health benefit costs for FM were

Medication adherence with disease modifying treatments for multiple sclerosis among US employees

8452 versus

Lost time, absence costs, and reduced productivity output for employees with bipolar disorder.

11,253 (P < 0.0001) for OA and

Objective measurement of work absence and on-the-job productivity: a case-control study of US employees with and without gastroesophageal reflux disease.

4013 (P < 0.0001) for NoFM, with BOI =

Incremental Employee Health Benefit Costs, Absence Days, and Turnover Among Employees With ADHD and Among Employees With Children With ADHD

4439. Total absence days were 16.8 versus 19.8 (P < 0.0001) and 6.4 (P < 0.0001), respectively. FM had significantly lower annual work output than NoFM (19.5%, P = 0.003) but comparable with OA. Conclusion: FM places a significant cost, absence, and productivity burden on employers.

Metabolic syndrome-related conditions among people with and without gout: prevalence and resource use

Abstract Objective: Medication adherence in chronic diseases like multiple sclerosis (MS) plays an important role in predicting long-term outcomes, yet existing data on adherence in employee populations are not found. The objective of this study is to compare adherence among employees treated with disease modifying treatments (DMTs) for MS in the year following treatment initiation. Methods: A healthcare claims database of US employees from 2001 to 2008 was used to identify patients with MS based on two or more DMT prescriptions or one DMT prescription with an MS diagnosis (ICD-9 340.xx). Employees continuously employed and with health plan coverage for 1 year following DMT initiation were eligible. Two measures were used in estimating adherence after DMT initiation: (1) persistence (the number of days from DMT initiation to the first 30-day gap in supply) and, (2) annual compliance, assessed by the medication possession ratio (MPR = number of days with a medication supply in the year divided by 365 days). Wilcoxon tests on time-to-event data and t-tests were used to compare persistence and MPR, respectively, between DMT groups. Other measures of resource utilization were also compared. Results: Overall, 358 employees [179 interferon [IFN]-β1a-IM (Avonex* = ‘A’); 63 IFN-β1b (Betaseron† = ‘B’); 20 IFN-β1a-SC (Rebif‡ = ‘R’); 96 glatiramer acetate (Copaxone§ = ‘C’)] were eligible for analysis. No significant differences in age, gender, and certain job-related variables existed between cohorts. Persistence was better for ‘A’ than ‘B’ (p = 0.039), ‘C’ (p = 0.0007), and ‘R’ (p = 0.130). At 1 year, a greater proportion of ‘A’ employees were persistent (60.34%) than ‘B’ (42.86%, p = 0.016), ‘C’ (42.71%, p = 0.0052), and ‘R’ (45.00%, p = 0.190). ‘A’ also had the highest MPR (0.782) which was significantly higher than ‘C’ (MPR = 0.698, p = 0.0160) and statistically equivalent to ‘B’ (MPR = 0.705, p = 0.0576) and ‘R’ (MPR = 0.761, p = 0.7347). * Avonex is a registered trade name of Biogen Idec Pharmaceuticals, Cambridge, MA, USA. † Betaseron is a registered trademark of Bayer HealthCare Pharmaceuticals Inc., West Haven, CT, USA. ‡ Rebif is a registered trademark of EMD Serono, Inc. Rockland, MA, USA and its affiliates. § Copaxone is a registered trademark of Teva Pharmaceutical Industries Ltd., Petach Tikva, Israel. Limitations: The study has limitations characteristic of administrative claims database studies and small sample sizes. The population may not be representative of undiagnosed/untreated MS patients, those not able to maintain employment, and those not using the initial therapy. Conclusions/relevance: Among employees treated with ‘A’, ‘B’, ‘C’, and ‘R’ for MS, ‘A’ patients had significantly greater medication adherence.

Costs of physical and mental comorbidities among employees: a comparison of those with and without bipolar disorder.

Objective:We sought to evaluate the incremental health-related lost work time and at-work productivity loss for employees with bipolar disorder (BPD). Methods:Health-related absence and real productivity output of employees with BPD were compared with that of non-BPD and other employee cohorts from a large employer database using multivariate regression to control for cohort differences. Results:After adjusting for confounding factors, employees with BPD had significantly higher absence costs (

The impact of morbid obesity and bariatric surgery on comorbid conditions: a comprehensive examination of comorbidities in an employed population.

1219) and 11.5 additional lost days (P < 0.05) per year than those without BPD. Adjusted annual productivity output was 20% lower for the BPD group (P < 0.05). Conclusions:Employees with BPD are less likely to be present for work. When present, their productivity level is similar to that of other employees, but over the course of a year, their absence rates result in significant productivity losses.

Absenteeism and health-benefit costs among employees with MS

Objective: To establish an association between gastroesophageal reflux disease (GERD) and increased work absence, as well as reduced productivity while at work, by using objective productivity measurements. Methods: Retrospective case-control analysis of a database containing US employees’ administrative health care and payroll data for employees (N = 11,653 with GERD; N = 255,616 without GERD) who were enrolled for at least one year in an employer-sponsored health insurance plan. Results: Employees with GERD had 41% more sick leave days (P < 0.0001), 59% more short-term disability days (P < 0.0001), 39% more long-term disability days (P = 0.1910), 48% more workers’ compensation days (P < 0.0001), 4.4% lower objective productivity per hour worked (P = 0.0481), and 6.0% lower annual objective productivity (P = 0.0391) than the employees without GERD. Conclusions: GERD is associated with a significant impact on employees’ work absence and productivity while at work as measured using objective data.