In Canada, many payers think about the price of medication alone and don’t consider the costs of productivity loss if employees don’t use a drug, according to Professor Aslam Anis of the School of Population and Public Health at the University of British Columbia.
At the 2016 Face-to-Face Drug Plan Management conference in Vancouver in May, Anis explained how drug evaluations for cost effectiveness overlook the costs associated with increased presenteeism, the productivity loss that occurs when an employee shows up to work but doesn’t work at full capacity.
“So you’re doing cost-effectiveness analysis and you’re looking at treatment costs for the drug, hospitalization costs for the condition, but the associated productivity impact is not being considered,” said Anis.
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He said that when comparing just the acquisition cost of a new drug to an old one, the price difference can be large. But after looking at other costs, such as whether someone on the old drug may need additional physician care, hospitalization, surgery, tests or other medication, the difference may not be as vast.
And with the productivity impact as well, the cost difference may be even smaller. “If you add the productivity loss associated with the new drug and the productivity loss associated with the old drug, or the productivity saving, the equation can be reversed,” said Anis.
At the conference, Anis presented evidence demonstrating that considering cost effectiveness with and without productivity loss can make a difference. He highlighted an empirical study that estimated the monetary value of the annual productivity gained in patients who were taking Etanercept and Methotrexate.
The study found that responders who took that combination in therapy showed significant productivity gains at the 13th week when compared to non-responders. The findings suggest that the increase in productivity was related to the treatment response.
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Anis said there are problems with ignoring productivity impacts, such as misallocating resources, ignoring loss of income for plan members and loss of production for employers. “By doing this, you’re ignoring drugs that lead to productivity improvements in society, which is very important,” he said.
“We need a better measurement of productivity loss due to poor health. We need to understand the burden of illness when you include indirect costs. We have to include the true gain to society from different treatments and insist on proper methodology to evaluate the productivity impact.”
Read more from the Face-to-Face Drug Plan Management conference