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Imputing Productivity Gains From Clinical Trials

Cangelosi, Michael J. MA, MPH; Bliss, Sarah BA; Chang, Hong PhD; Dubois, Robert W. MD, PhD; Lerner, Debra MS, PhD; Neumann, Peter J. ScD; Westrich, Kimberly MA; Cohen, Joshua T. PhD

Journal of Occupational and Environmental Medicine: July 2012 - Volume 54 - Issue 7 - p 826–833
doi: 10.1097/JOM.0b013e31825b1bd2
Original Articles

Objective: To respond to employer and payer interest in the extent to which productivity gains offset therapy costs by identifying clinical trials that did not include such measures and using their clinical data to impute productivity impact.

Methods: A PubMed search identified the sample of 25 clinical trials of musculoskeletal pain medications and antidepressants. Next, we applied regression coefficients, quantifying the empirical relationship between clinical measures to each trial's clinical outcomes data. This validated methodology provides estimates of Work Limitations Questionnaire Productivity Loss scores.

Results: Based on imputation, musculoskeletal medications and antidepressants achieved median productivity gains of approximately 0.5% and 1.0%, respectively.

Conclusion: Accounting for productivity gains based on the Work Limitations Questionnaire could substantially influence cost-effectiveness results reported in the health economics literature.

Supplemental Digital Content is available in the text.

From the Center for the Evaluation of Value and Risk in Health (Mr Cangelosi, Ms Bliss, and Drs Neumann and Cohen) and The Health Institute (Drs Chang and Lerner), Tufts Medical Center, Boston, Mass; and National Pharmaceutical Council, Washington, DC (Dr Dubois and Ms Westrich).

Address correspondence to: Joshua T. Cohen, PhD, Tufts Medical Center, 800 Washington Street, Box #063, Boston, MA 02111 (

Disclosure: The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Note: Full references appear here for nine studies cited only in the Supplemental Digital Content (Refs 46–54).

©2012The American College of Occupational and Environmental Medicine