Work productivity loss and indirect costs associated with new cardiovascular events in high-risk patients with hyperlipidemia: estimates from population-based register data in Sweden

• Published in: The European journal of health economics 2016-12, Vol.17 (9), p.1117-1124
• Main Authors: Banefelt, J., Hallberg, S., Fox, K. M., Mesterton, J., Paoli, C. J., Johansson, G., Levin, L.-Å., Sobocki, P., Gandra, S. R.
• Format: Article
• Language: English
• Subjects: Adult; Angina pectoris; Angioplasty; Anticholesteremic Agents - therapeutic use; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - complications; Cardiovascular Diseases - economics; Cost estimates; Cost of Illness; Disability pensions; Economic Policy; Efficiency; Female; Health Care Costs - statistics & numerical data; Health Care Management; Health Economics; Heart attacks; Humans; Hyperlipidemia; Hyperlipidemias; Hyperlipidemias - complications; Hyperlipidemias - drug therapy; Indirect labor costs; Industrial productivity; Ischemia; Logistic Models; Male; Medical records; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Middle Aged; Myocardial infarction; Original Paper; Patients; Pensions; Pharmacoeconomics and Health Outcomes; Population; Primary care; Productivity; Public Finance; Public Health; Registries; Retrospective Studies; Risk Factors; Sick Leave; Social insurance; Stroke; Strokes; Studies; Sweden; Transient ischemic attack; Young Adult
• ISSN: 1618-7598; 1618-7601; 1618-7601
• DOI: 10.1007/s10198-015-0749-y

Objectives To estimate productivity loss and associated indirect costs in high-risk patients treated for hyperlipidemia who experience cardiovascular (CV) events. Methods Retrospective population-based cohort study conducted using Swedish medical records linked to national registers. Patients were included based on prescriptions of lipid-lowering therapy between 1 January 2006 and 31 December 2011 and followed until 31 December 2012 for identification of CV events and estimation of work productivity loss (sick leave and disability pension) and indirect costs. Patients were stratified into two cohorts based on CV risk level: history of major cardiovascular disease (CVD) and coronary heart disease (CHD) risk equivalent. Propensity score matching was applied to compare patients with new events (cases) to patients without new events (controls). The incremental effect of CV events was estimated using a difference-in-differences design, comparing productivity loss among cases and controls during the year before and the year after the cases' event. Results The incremental effect on indirect costs was largest in the CHD risk equivalent cohort (n = 2946) at €3119 (P value