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Arthritis Care Res (Hoboken). 2018 Apr 12. doi: 10.1002/acr.23573. [Epub ahead of print]

Excess Productivity Costs of Systemic Lupus Erythematosus, Systemic Sclerosis, and Sjogren's Syndrome: A General Population-Based Study.

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University of British Colmbia, Faculty of Pharmaceutical Sciences, Arthritis Research Centre of, Canada.



Determine excess productivity losses and costs of systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and Sjogren's syndrome (SjS) at the population level.


Administrative databases from the province of British Columbia, Canada, were used to establish population-based cohorts of SLE, SSc, and SjS, and matched comparison cohorts selected from the general population. Random samples from these cohorts were surveyed about time absent from paid and unpaid work, and working at reduced levels/efficiency (presenteeism), using validated labour questionnaires. We estimated excess productivity losses and costs of each diagnosis (over-and-above non-SARDs), using two-part models, and work disability rates (not-employed, due to health).


Surveys were completed by 167 SLE, 42 SSc, 90 SjS, and 375 non-SARDs (comparison group). Altogether, predicted excess hours of paid and unpaid work loss were 3.5, 3.2, and 3.4 per-week for SLE, SSc, and SjS, respectively; excess costs of $86, $69, and $84 (2015 Canadian) per-week, or $4,494, $3,582, and $4,357 per-person annually. Costs for productivity losses from paid work stemmed mainly from presenteeism (SLE=69% of costs, SSc=67%, SjS=64%, non-SARDs=53%), not absenteeism. However, many working-age patients were not-employed at all, due to health (SLE=36%, SSc=32%, SjS=30%, non-SARDs=18%), and majority of total productivity costs were from unpaid work loss (SLE=73% of costs, SSc=74%, SjS=60%, non-SARDs=47%). Adjusted excess costs from these unpaid production losses were $127, $100, and $82 per-week, respectively, among SLE, SSc, and SjS.


In this population-based sample of prevalent SLE, SSc, and SjS, lost productivity costs were substantial, mainly from presenteeism and unpaid work impairments. This article is protected by copyright. All rights reserved.


Economics; Employment; Sjogren's syndrome; indirect costs; presenteeism; productivity costs; productivity loss; systemic lupus erythematosus; systemic sclerosis; work disability


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