title: The cost of disability and medically related absenteeism among employees with multiple sclerosis in the US.
abstract: Studies have not previously reported the indirect cost burden of multiple sclerosis (MS) from an employer perspective. To compare annual indirect costs between privately insured US employees with MS and matched employee controls. A retrospective analysis of a privately insured claims database containing disability data from 17 US companies was conducted. Employees with >/=1 MS diagnosis (ICD-9-CM: 340.x) after 1 January 2002, aged 18-64 years, were selected. Employees with MS were matched by age and sex to employee controls without MS. All were required to have continuous health coverage 3 months before MS diagnosis (baseline) and 12 months after (study period). Main outcomes measures included study period annual indirect (disability and medically related absenteeism) costs. For completeness, we also included measures of direct (medical and drug) costs. Chi-squared tests were used to compare baseline co-morbidities and differences in indirect resource use (disability and medically related absenteeism) between employees with MS and controls. Wilcoxon rank-sum tests were used for univariate comparisons of disability and medically related absenteeism days and associated annual indirect and direct costs between employees with MS and controls. Generalized linear models, controlling for differences in baseline characteristics, were used to estimate risk-adjusted annual costs for employees with MS and controls. Employees with MS (n = 989) averaged 44 years of age, and 66% were female. Compared with employee controls, employees with MS had significantly higher rates of mental health disorders, other neurological disorders and physical disorders measured by the Charlson Co-morbidity Index. Employees with MS were more likely to have short-term or long-term disability than employee controls (21.4% vs 5.2%, respectively; p < 0.0001), resulting in a higher mean number of disability days per year (29.8 vs 4.5; p < 0.0001). Employees with MS also had a higher rate of medically related absenteeism and associated absenteeism days than employee controls. On average, annual costs (year 2006 values) for disability were significantly higher for employees with MS ($US3868) than employee controls ($US414; p < 0.0001). Annual medically related absenteeism costs were also higher for employees with MS than for controls ($US1901 vs $US1003, respectively; p < 0.0001). On average, total annual indirect costs for employees with MS were $US5769 compared with $US1417 for controls (p < 0.0001). MS is a chronic and debilitating disease that poses a substantial employer burden in terms of medically related absenteeism and disability costs. Indirect costs of employees with MS were >4 times those of employee controls.
authors.affiliation: Analysis Group, Inc., New York, New York, USA. jivanova@analysisgroup.com
authors.forename: Jasmina I
authors.initials: JI
authors.lastname: Ivanova
authors.forename: Howard G
authors.initials: HG
authors.lastname: Birnbaum
authors.forename: Seth
authors.initials: S
authors.lastname: Samuels
authors.forename: Matthew
authors.initials: M
authors.lastname: Davis
authors.forename: Amy L
authors.initials: AL
authors.lastname: Phillips
authors.forename: Dennis
authors.initials: D
authors.lastname: Meletiche
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D017281:Cost of Illness; D017049:Employer Health Costs / Q000706:statistics & numerical data*; D004651:Employment / Q000191:economics; D006801:Humans; D018868:Insurance, Disability / Q000191:economics / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000191:economics*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014481:United States; D055815:Young Adult