title: Short-term influence of adalimumab on work productivity outcomes in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To evaluate the shortterm effect of adalimumab on work productivity in patients with moderate to severe active rheumatoid arthritis (RA).
  
  
  METHODS
  In a substudy of the Canadian Adalimumab Clinical Trial (CanAct), clinical, health status, and productivity outcomes were measured at baseline and 12 weeks. Patients were classified as responders and nonresponders by the 20% American College of Rheumatology (ACR20) improvement criterion and the minimum clinically important difference (MCID) of the Health Assessment Questionnaire (HAQ) score (0.22), respectively. The Health and Labour Questionnaire (HLQ) was used to measure productivity outcomes and costs.
  
  
  RESULTS
  Included in the analysis were 389 patients completing both baseline and 12-week HLQ questionnaire. Absenteeism (a decrease of 0.5 workdays per 2 weeks) and unpaid work productivity (3.5 fewer hours unpaid help per 2 weeks) were improved significantly after 12 weeks. Improvements in productivity outcomes were associated with clinical response. Bootstrapping results suggest that responders achieved statistically significant improvement in presenteeism (ACR20) and unpaid work productivity (ACR20 and HAQ) versus nonresponders. The costs saved by responders were up to $155.04 per 2 weeks more than those by nonresponders.
  
  
  CONCLUSIONS
  The costs of adalimumab were partially offset, even in the short term, by cost savings induced by clinical response among Canadian patients with moderate to severe RA. These findings complement results of other study analyses that demonstrate early and sustained benefits of adalimumab.
authors.affiliation: Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, British Columbia, Canada.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Nick
authors.initials: N
authors.lastname: Bansback
authors.forename: Daphne
authors.initials: D
authors.lastname: Guh
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.forename: Bohdan
authors.initials: B
authors.lastname: Nosyk
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Marra
authors.forename: Aslam H
authors.initials: AH
authors.lastname: Anis
mesh_terms: D000041:Absenteeism; D000068879:Adalimumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology; D004526:Efficiency / Q000187:drug effects*; D004651:Employment / Q000191:economics; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014938:Work Capacity Evaluation
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D000068879:Adalimumab