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Employer Model of Workplace Impacts of Anti-TNF Therapy for Rheumatoid Arthritis

Birnbaum, Howard PhD; Pike, Crystal MBA; Kaufman, Rebecca BA; Cifaldi, Mary PhD

Journal of Occupational and Environmental Medicine: October 2009 - Volume 51 - Issue 10 - p 1167-1176
doi: 10.1097/JOM.0b013e3181b8c397
Original Articles

Objective: Rheumatoid arthritis (RA) greatly affects patients’ abilities to perform work, which can translate into substantial employer costs. We developed a customizable model that allows employers to calculate workplace impacts of RA therapies in employees with RA.

Methods: Costs of medical leave (absenteeism)/disability, reduced productivity, job turnover, and work-equipment adaptations for employees with RA were calculated. Costs of the tumor necrosis factor antagonist adalimumab were compared with those of other RA treatments. Default parameters were based on literature, clinical trials, government sources, and employers’ data.

Results: Annual per-employee workplace cost was $9071 for adalimumab versus $16,335 for other RA therapies. Costs included reduced productivity (57%), absenteeism/disability (21%), and job turnover (21%).

Conclusion: RA imposes a large financial burden on employers, predominantly owing to lost productivity. When compared with other RA therapies, adalimumab substantially reduced employers’ costs.

From Analysis Group, Inc. (Dr Birnbaum, Ms Pike, Ms Kaufman), Boston, Mass; and Global Pharmaceutical Research and Development (Dr Cifaldi), Abbott Laboratories, Abbott Park, Ill.

This analysis was performed by Analysis Group, Inc., under contract with Abbott Laboratories. Dr. Birnbaum, Ms. Pike, and Ms. Kaufman are employees of Analysis Group. Dr. Cifaldi is an Abbott employee.

Address correspondence to: Howard Birnbaum, PhD, Analysis Group, 111 Huntington Avenue, 10th floor, Boston, MA 02199; E-mail:

©2009The American College of Occupational and Environmental Medicine