Underestimating the value of women: Assessing the indirect costs of women with systemic lupus erythematosus

Objective. Indirect costs result from diminished productivity and are incor porated in cost-benefit analysis to guide health resource allocation. Valui ng the productivity impairment of those not involved in labor market activi ties is controversial but important for diseases affecting predominantly wo men if allocation decisions are to be: economically efficient and equitable . We compared indirect costs incurred by women with systemic lupus erythema tosus (SLE), a prototypical women's disease, calculated under varying assum ptions for the value of diminished labor market and non-labor market activi ty. Methods. Six hundred forty-eight female patients with SLE reported on emplo yment status and time lost by themselves and their caregivers from labor ma rket and non-labor market activities over a 6 month period. Results. Average annual indirect costs ranged from $1421 to $22,604 (1997 C anadian dollars) dependent on the value assigned to labor market and non-la bor market activity. Conclusion. Indirect cost estimates that fail to consider longterm labor ma rket absenteeism and diminished non-labor market productivity and do not us e gender neutral wages to value labor market activity may lead to decisions that jeopardize resources for women's diseases.