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Short-term Influence of Adalimumab on Work Productivity Outcomes in Patients with Rheumatoid Arthritis
WEI ZHANG, NICK BANSBACK, DAPHNE GUH, XIN LI, BOHDAN NOSYK, CARLO A. MARRA, and ASLAM H. ANIS
ABSTRACT. 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. Conclusion. 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. (First Release Aug 1 2008; J Rheumatol 2008;35:1729-36) Key Indexing Terms:
RHEUMATOID ARTHRITIS From the Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, British Columbia, Canada. Supported by Abbott Laboratories, Saint-Laurent, Quebec, Canada. W. Zhang, MA; N. Bansback, MSc, Health Economist; D. Guh, MSc, Statistician, Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, BC; X. Li, PhD, Postdoctoral Fellow, School of Population and Public Health, University of British Columbia, Vancouver; B. Nosyk, MA, Health Economist, Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital; C.A. Marra, PharmD, PhD, Assistant Professor, Faculty of Pharmaceutical Sciences, University of British Columbia, Scientist, Centre for Health Evaluation and Outcome Sciences; A.H. Anis, PhD, Director, Centre for Health Evaluation and Outcome Sciences, and Professor, School of Population and Public Health, University of British Columbia. Address reprint requests to A.H. Anis, Centre for Health Evaluation and Outcome Sciences, 620-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. E-mail: aslam.anis@ubc.ca Accepted for publication April 17, 2008. |
