Excess Productivity Costs of Systemic Lupus Erythematosus, Systemic Sclerosis, and Sjögren's Syndrome: A General Population–Based Study

Objective To determine excess productivity losses and costs of systemic lupus erythematosus ( SLE ), systemic sclerosis ( SS c), and Sjögren's syndrome ( SS ) at the population level. Methods Administrative databases from the province of British Columbia, Canada, were used to establish population‐based cohorts of SLE , SS c, and SS , and matched comparison cohorts were 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 labor questionnaires. We estimated excess productivity losses and costs of each diagnosis (over and above nonsystemic autoimmune rheumatic diseases [non‐ SARD s]), using 2‐part models and work disability rates (not employed due to health). Results Surveys were completed by 167 SLE , 42 SS c, and 90 SS patients, and by 375 non‐ SARD s (comparison group) participants. Altogether, predicted excess hours of paid and unpaid work loss were 3.5, 3.2, and 3.4 hours per week for SLE , SS c, and SS patients, respectively. Excess costs were $86, $69, and $84 (calculated as 2015 Canadian dollars) per week, or $4,494, $3,582, and $4,357 per person annually, respectively. Costs for productivity losses from paid work stemmed mainly from presenteeism ( SLE = 69% of costs, SS c = 67%, SS = 64%, and non‐ SARD s = 53%), not from absenteeism. However, many working‐age patients were not employed at all, due to health ( SLE = 36%, SS c = 32%, SS = 30%, and non‐ SARD s = 18%), and the majority of total productivity costs were from unpaid work loss ( SLE = 73% of costs, SS c = 74%, SS = 60%, and non‐ SARD s = 47%). Adjusted excess costs from these unpaid production losses were $127, $100, and $82 per week, respectively, among SLE , SS c, and SS patients. Conclusion In this population‐based sample of prevalent SLE , SS c, and SS , lost productivity costs were substantial, mainly from presenteeism and unpaid work impairments.