Do the Washington Panel recommendations hold for europe inversigating the relation between quality of life versus work-status, absenteeism and presenteeism

Abstract

__Abstract__ \n \nBackground: The question of how to value lost productivity in economic evaluations has been subject of debate \nin the past twenty years. According to the Washington panel, lost productivity influences health-related quality of \nlife and should thus be considered a health effect instead of a cost to avoid double counting. Current empirical \nevidence on the inclusion of income loss when valuing health states is not decisive. We examined the relationship \nbetween three aspects of lost productivity (work-status, absenteeism and presenteeism) and patient or social \nvaluation of health-related quality of life (HRQoL). \nMethods: Cross-sectional survey data were collected from a total of 830 respondents with a rheumatic disorder \nfrom four West-European countries. Health-related quality of life was expressed in either the European societal utility \nusing EQ-5D-3L or the patient valuation using EQ-VAS. The impact of work-status (four categories), absenteeism \n(absent from paid work during the past three months), and presenteeism (QQ method) on EQ-5D utilities and VAS \nscores was examined in linear regression analyses taking into account demographic characteristics and disease \nseverity (duration, pain and restriction). \nResults: The relationship between work-status, absenteeism or presenteeism and HRQoL was stronger for patient \nvaluation than societal valuation. Compared to work-status and presenteeism the relationship between absenteeism \nand HRQoL was even less explicit. However, results for all measures of lost productivity are only marginally significant \nand negligible compared to the influence of disease-related restrictions. \nConclusions: This survey study in patients with a rheumatic disorder in four European countries, does not fully support \nthe Washington panel\xe2\x80\x99s claim that lost productivity is a significantly related with HRQoL, and this is even more apparent \nfor absenteeism than for work-status and presenteeism. For West-European countries, there is no reason, to include \nabsenteeism in the QALY. Findings need to be confirmed in other disease areas