title: Underestimating the value of women: assessing the indirect costs of women with systemic lupus erythematosus. Tri-Nation Study Group.
abstract: OBJECTIVE
  Indirect costs result from diminished productivity and are incorporated in cost-benefit analysis to guide health resource allocation. Valuing the productivity impairment of those not involved in labor market activities is controversial but important for diseases affecting predominantly women if allocation decisions are to be economically efficient and equitable. We compared indirect costs incurred by women with systemic lupus erythematosus (SLE), a prototypical women's disease, calculated under varying assumptions for the value of diminished labor market and non-labor market activity.
  
  
  METHODS
  Six hundred forty-eight female patients with SLE reported on employment status and time lost by themselves and their caregivers from labor market and non-labor market activities over a 6 month period.
  
  
  RESULTS
  Average annual indirect costs ranged from $1,424 to $22,604 (1997 Canadian dollars) dependent on the value assigned to labor market and non-labor market activity.
  
  
  CONCLUSIONS
  Indirect cost estimates that fail to consider longterm labor market absenteeism and diminished non-labor market productivity and do not use gender neutral wages to value labor market activity may lead to decisions that jeopardize resources for women's diseases.
authors.affiliation: Department of Medicine, Montreal General Hospital, Quebec, Canada. annc@bic.mni.mcgill.ca
authors.forename: A E
authors.initials: AE
authors.lastname: Clarke
authors.forename: J
authors.initials: J
authors.lastname: Penrod
authors.forename: Y
authors.initials: Y
authors.lastname: St Pierre
authors.forename: M A
authors.initials: MA
authors.lastname: Petri
authors.forename: S
authors.initials: S
authors.lastname: Manzi
authors.forename: D A
authors.initials: DA
authors.lastname: Isenberg
authors.forename: C
authors.initials: C
authors.lastname: Gordon
authors.forename: J L
authors.initials: JL
authors.lastname: Senecal
authors.forename: P R
authors.initials: PR
authors.lastname: Fortin
authors.forename: N
authors.initials: N
authors.lastname: Sutcliffe
authors.forename: J R
authors.initials: JR
authors.lastname: Goulet
authors.forename: D
authors.initials: D
authors.lastname: Choquette
authors.forename: T
authors.initials: T
authors.lastname: Grodzicky
authors.forename: J M
authors.initials: JM
authors.lastname: Esdaile
mesh_terms: D000041:Absenteeism; D000328:Adult; D017281:Cost of Illness; D004651:Employment; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000191:economics*; D008875:Middle Aged; D016387:Women's Health