Productivity losses associated with cardiovascular disease: a systematic review

ABSTRACT

Introduction: People with cardiovascular disease (CVD) often require time off work to recover from illness or surgery; for example, following a myocardial infarction (MI) or stroke. These individuals incur income losses, work-related productivity is reduced for employers, and output is reduced for the wider economy. Productivity impacts to the economy also arise due to CVD-related mortality.

Areas covered: A systematic literature review was conducted to identify and collate studies that report the magnitude of work-related productivity losses associated with CVD generally or specific cardiovascular (CV) events or conditions (coronary heart disease, MI, stroke, transient ischemic attack, angina, heart failure, peripheral artery disease, coronary revascularization). The search was conducted using Medline, Embase, the Cochrane Library, and Google to find studies published from January 2004 to January 2015. In total, 60 studies were identified, including 20 studies conducted in the USA, 25 studies conducted in Europe, and 18 studies conducted in other countries (three studies were conducted in multiple regions). The studies differed by the scope of losses assessed (absenteeism, presenteeism, early retirement, premature mortality) and CVD conditions/events included. Studies reported either average patient or population losses, and generally used a human capital rather than friction cost method. Outcomes were standardized and adjusted to 2015 US dollars where possible.

Expert commentary: The review demonstrates that CVD imposes substantial morbidity- and mortality-related productivity costs. The studies identified in the review may be used to inform and populate societal economic evaluations in CVD, with the most appropriate source study being that most closely matching the context of the evaluation.

KEYWORDS:

• Absenteeism
• cardiovascular
• cost
• presenteeism
• productivity
• review
• systematic

Declaration of interest

AL Gordois is an employee of Covance Market Access Services Inc., which received the funding. RGW Quek, CJ Paoli and SR Gandra are stockholders of Amgen Inc. RGW Quek and SR Gandra are employees of Amgen Inc. PP Toth is a consultant and member of the speakers’ bureau for Amgen. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Contribution statement

ALG and EMP designed and carried out the searches, and extracted, analyzed and interpreted the data. ALG produced the draft of the manuscript. CJP and SRG contributed to the design and oversaw the development of the work. CJP, SRG, PPT and RGWQ contributed to data interpretation, the various drafts of the manuscript and provided guidance. All authors read and approved the final manuscript.

Additional information

Funding

This study was funded by Amgen Inc.