(77) Productivity losses among individuals diagnosed with narcolepsy or idiopathic hypersomnia

Background: : Narcolepsy and idiopathic hypersomnia (IH) are associated with higher comorbidity burden and healthcare costs, compared to the general population; however, data on productivity losses and associated indirect costs are limited.

Objective: : To describe productivity losses and direct and indirect costs in individuals with narcolepsy or IH compared with individuals without narcolepsy or IH, respectively.

Methods: : MarketScan® linked to the Health and Productivity Management (HPM) Database (01/2017‒12/2023) was used to identify individuals with narcolepsy or IH (using ICD-10 diagnosis codes), propensity-score matched 1:2 to individuals without narcolepsy or IH, respectively, on demographics and matched diagnosis (index) date. Inclusion criteria included age 18–65 years and 365 days of continuous medical, pharmacy, and HPM enrollment in both the pre- and post-index periods. Short-term disability (STD), long-term disability (LTD), workplace absence (WA), and workers’ compensation (WC) days missing from work and their corresponding indirect costs were descriptively analyzed.

Results: : A higher proportion of individuals with narcolepsy had a claim for STD (n=351/2553; 13.7%) compared with non-narcolepsy (n=404/5106; 7.9%); LTD (n=16/2553; 0.6% vs n=28/5106; 0.5%) and WC (n=56/1812 vs n=111/3624; both 3.1%) claims were similar between groups. A smaller proportion of individuals with narcolepsy had WA claims (n=205/407; 50.4% vs n=509/814; 62.5%). Individuals with narcolepsy had 18 more days of STD off, 30 more days of LTD off, and 0.5 more days of WA off, but had 6 fewer days of WC off. This corresponded to higher STD ($2983), LTD ($4977), and WA ($74) indirect costs, but lower WC ($882) indirect costs in individuals with narcolepsy compared with non-narcolepsy. A higher proportion of individuals with IH vs non-IH had a claim for STD (n=99/950; 10.4% vs n=151/1900; 7.9%), LTD (n=7/950; 0.7% vs n=8/1899; 0.4%), WC (n=23/597; 3.9% vs n=34/1194; 2.9%), and WA (n=140/179; 78.2% vs n=243/358; 67.9%). Compared with non-IH individuals, individuals with IH had more STD (1), LTD (6), WC (14), and WA (1) days off, corresponding to higher STD ($144), LTD ($899), WC ($2372), and WA ($129) indirect costs.

Conclusions: : Individuals with narcolepsy or IH had higher indirect costs than those without these conditions, due to higher disability work absences and associated productivity losses. Findings underscore the need for improved management to mitigate excess personal and societal costs.

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