Z Gastroenterol 2014; 52 - A42
DOI: 10.1055/s-0034-1376102

Productivity loss and work disability in patients with inflammatory bowel diseases in Hungary in the era of biologics

M Mandel 1, A Bálint 2, B Lovász 1, P Golovics 1, K Farkas 2, Z Kürti 1, B Szilágyi 1, A Mohás 1, T Molnár 2, P Lakatos 1
  • 11st Department of Medicine, Semmelweis University, Budapest, Hungary
  • 21st Department of Medicine, University of Szeged, Szeged, Hungary

Background and Aims: To assess work disability (WD) and disability pension (DP) rates in a referral inflammatory bowel disease (IBD) involving patients with Crohn's disease (CD) or ulcerative colitis (UC) cohort and to identify possible clinical or demographic factors associated with WD.

Methods: Data from 443 (M/F: 202/241, CD/UC: 260/183, median age: 34 (CD) and 41 (UC) years, biological drug exposure 31.2%/11.5%)) consecutive patients were included UC. WD data were collected by questionnaire and the Work Productivity and Activity Impairment (WPAI) instrument. Disability pension (DP) rates in the general population were retrieved from public databases.

Results: Among employed patients, absenteeism and presenteeism was reported in of 25.9% and 60.3% patients, respectively, leading to a 28% loss of work productivity and a 32% activity loss, and was associated with disease activity and age group. Average cost of productivity loss due to disability and sick leave with human capital approach was 1450 and 430 €/patient/year, respectively (total indirect cost 1880 €/patient/year. The overall DP rate in this referral population was 32.3%, with partial disability in 24.2%. Of all DP events, 88.8% were directly related to IBD. Overall, full DP was more prevalent in IBD (RR:1.51, p < 0.001) and CD (RR:1.74, p < 0.001) but not in UC compared to the general population and in CD compared to UC (OR: 1.57, p = 0.03). RR for full DP was increased only in young CD patients (RR< 35 year olds: 9.4; RR36 – 40 year olds: 9.4 and 5.6, p < 0.01 for both). In CD, age group, previous surgery, disease duration, frequent relapses, and the presence of arthritis/arthralgia were associated with an increased risk for DP.

Conclusion: Work productivity is significantly impaired in IBD and is associated with high productivity loss and indirect costs. Risk of DP was highly increased in young CD patients (six to nine fold). Previous surgery and presence of arthritis/arthralgia was identified as risk factor for DP.