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. 2023 Sep;41(9):1079-1091.
doi: 10.1007/s40273-023-01269-4. Epub 2023 Apr 21.

Productivity Loss Across Socioeconomic Groups Among Patients With Low Back Pain or Osteoarthritis: Estimates Using the Friction-Cost Approach in Norway

Johan A Liseth Hansen  1   2 , Thomas Fast  3 , Knut Reidar Wangen  4
Affiliations

Productivity Loss Across Socioeconomic Groups Among Patients With Low Back Pain or Osteoarthritis: Estimates Using the Friction-Cost Approach in Norway

Johan A Liseth Hansen et al. Pharmacoeconomics. 2023 Sep.

Abstract

Objectives: Our aim was to estimate the productivity loss (PL) among patients with low back pain (LBP) or osteoarthritis (OA) across socioeconomic groups, using the friction-cost approach (FCA).

Methods: A total of 175,550 patients aged 18-65 years were included at their first diagnosis in specialty care between 2011 and 2016. PL was calculated for the year following diagnosis using individual wages, while adjusting for the friction length at 78 days per episode, a team production multiplier at 1.6, compensation mechanisms of 26.8%, and a chain-of-vacancies multiplier at 3.95. We included a simpler FCA model, omitting the latter three parameters, and a human capital approach (HCA) model. Socioeconomic stratifications were created based on education and income. One-way sensitivity analysis was used to assess the influence of the parameters in the full FCA model.

Results: The overall mean number of absent days was 23, while it was 25.3 and 20.1 for those with low and high education levels. The per-patient friction costs were €4395 among all patients and when extending the friction length to 98 days costs were €4342. For those with low and high education levels, the costs were €3671 and €4464, respectively. The costs in the simple FCA and HCA models were €1539 and €2088.

Discussion: Socioeconomic status and model design are sources of variation in PL. In health economic applications with PL and in patient populations with large socioeconomic differences, adjusting for these factors may be as important as sensitivities in parameters such as the friction length.

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Conflict of interest statement

Johan A. Liseth Hansen and Thomas Fast are employees of Quantify Research, a consultancy firm providing services to public and private entities, including pharmaceutical companies. Knut Reidar Wangen declares no competing interests.

Figures

Fig. 1
Fig. 1
The proportion of patients with a specific (or higher) number of work absence days according to socioeconomic group. The figure does not include the proportion with 0 work absence days for visual clarity
Fig. 2
Fig. 2
One-way sensitivity analysis. The bars for the socioeconomic groups are found by subtracting the extended model costs for that group from the extended model cost of all patients, e.g., cost for higher than upper secondary school was €12,256 yielding a difference of €800 as indicated by the graph
Fig. 3
Fig. 3
Probabilistic sensitivity analysis with the density distribution of the mean probabilistic sensitivity analysis estimates in Euros. The numbers below each group are the mean, standard deviation, and median of the associated distribution
See this image and copyright information in PMC

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