Different approaches to valuing the lost productivity of patients with migraine

Objective: To calculate and compare the human capital approach (HCA) and fr iction cost approach (FCA) methods for estimating the cost of lost producti vity of migraineurs after the initiation of sumatriptan from a US societal perspective. Design: Secondary, retrospective analysis to a prospective observational st udy. Setting: A mixed-model managed care organisation in western Pennsylvania, U SA. Patients: Patients with migraine using sumatriptan therapy. Interventions: Patient-reported questionnaires collected at baseline, 3 and 6 months after initiation of sumatriptan therapy. Outcome measures: The cost of lost productivity estimated with the HCA and FCA methods, Results: Of the 178 patients who completed the study, 51% were full-time em ployees, 13% were part-time, 18% were not working and 17% changed work stat us. Twenty-four percent reported a clerical or administrative position. Fro m the HCA. the estimated total cost of lost productivity for 6 months follo wing the initiation of sumatriptan was $US 117 905 (1996 values). From the FCA, the six-month estimated total cost of lost productivity ranged from $U S28 329 to $US 117 905 (1996 values). Conclusions: This was the first study to retrospectively estimate lost prod uctivity of patients with migraine using the FCA methodology. Our results d emonstrate that depending on the assumptions and illustrations employed, th e FCA can yield lost productivity estimates that vary greatly as a percenta ge of the HCA estimate. Prospective investigations are needed to better det ermine the components and the nature of the lost productivity for chronic e pisodic diseases such as migraine headache.