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The Health Care and Productivity Costs of Back and Neck Pain in A Multi-Employer Sample of Utility Industry Employees

Lerner, Debra MS, PhD; Rogers, William H. PhD; Chang, Hong PhD; Rodday, Angie Mae MS; Greenhill, Annabel MA; Villagra, Victor G. MD, FACP; Antetomaso, James R. BS; Patel, Aarti A. PharmD, MBA; Vo, Lien PharmD, MPH

Journal of Occupational and Environmental Medicine: January 2015 - Volume 57 - Issue 1 - p 32–43
doi: 10.1097/JOM.0000000000000280
Original Articles

Objective: To determine the cost of back and/or neck (B/N) pain among predominantly rural employees insured through an employee benefits trust.

Methods: Eligible employees had 1 year or more of medical coverage and completed a survey subsequently linked to their claims data. B/N pain costs consisted of medical and pharmacy claims, over-the-counter expenses, and presenteeism and absenteeism costs valued according to median occupational earnings.

Results: Of 1342 eligible employees, 52.7% currently had B/N pain of which 87.9% was chronic. The average annualized cost of B/N pain per employee was $1727; 56.1% was due to lost productivity. Covered medical care was utilized by 35.6% of employees, 55.7% used pharmacy care, and 71.6% purchased uncovered over-the-counter pain medication.

Conclusions: Many covered employees did not use formal care. The effect of care choices on productivity costs requires closer scrutiny.

Supplemental Digital Content is Available in the Text.

From the Program on Health, Work and Productivity (Drs Lerner, Rogers, and Chang, Ms Rodday, and Ms Greenhill), Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA; National Rural Electric Cooperative Association (Dr Villagra and Mr Antetomaso), Arlington, VA; and Janssen Scientific Affairs, LLC (Dr Patel and Dr Vo), Raritan, N.J.

Address correspondence to: Debra Lerner, MS, PhD, Program on Health, Work and Productivity, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington St, Box 345, Boston, MA 02111 (

Study procedures, including compliance with HIPAA regulations, were reviewed and approved by the Tufts Medical Center and Tufts University Health Sciences Institutional Review Board. Source of funding: Janssen Scientific Affairs, LLC, Raritan, NJ, USA.

Conflicts of interest: None declared.

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

Copyright © 2015 by the American College of Occupational and Environmental Medicine