scholarly journals The economic impact of air pollution: a European assessment

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Conti ◽  
P Ferrara ◽  
L S D'Angiolella ◽  
S C Lorelli ◽  
G Agazzi ◽  
...  
Keyword(s):  
Air Pollution ◽  
Economic Burden ◽  
Indirect Costs ◽  
Premature Mortality ◽  
Cochrane Library ◽  
Policy Makers ◽  
Life Years ◽  
Health Related ◽  
Disease Study ◽  
The Impact

Abstract Background In 2017, the Global Burden of Disease Study estimated that in Europe 0.42 million deaths and 8.9 million disability-adjusted life years were attributable to air pollution. Monetizing this burden is a key step for estimating benefits of exposure reduction strategies. However, robust and synthetic estimates of direct (e.g. due to hospitalizations or medications) and indirect (e.g. due to premature mortality or loss of productivity) health-related costs of air pollution seem to be still lacking. We carried out a systematic review, aimed at identifying evidence from research in Europe. Methods We searched 5 electronic databases (MEDLINE, EMBASE, Cochrane Library, SCOPUS, Web Of Science) in which we applied algorithms tracing keywords such as “cost of illness”, “health care costs”, “economics” and synonyms, together with “air pollution” and synonyms. We limited our search to articles written in English and Italian, without date restriction. Results The initial search retrieved 2420 records. 200 were classified as relevant, and 38 fulfilled inclusion criteria. Most of them (68%) were published after 2010. 26% were multi-country studies, while the remaining focused on a single country or city. Investigated pollutants were usually particulate matter (79% of the studies) and nitrogen oxides (37%). The approaches to the economic analysis were heterogeneous: estimates could include direct and/or indirect costs. Among the studies, the most comprehensive one (12 countries) estimated that complying with WHO guidelines would avert €31 billion yearly, of which €19 million due to hospitalizations. Conclusions Over the last decade, progress has been made in evaluating the economic burden of air pollution. However, estimates based on indirect costs are affected by high levels of uncertainty, while those based on direct costs are more robust and should be further investigated, since they are crucial information for healthcare policy makers. Key messages Air pollution poses a high economic burden on European countries, mainly due to social costs. More attention should be devoted to estimating direct healthcare costs of air pollution, in order to properly inform policy makers about the impact on healthcare systems.

scholarly journals Estimation of the economic burden of COVID-19 using disability-adjusted life years (DALYs) and productivity losses in Kerala, India: a model-based analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049619
Author(s):  
Denny John ◽  
M S Narassima ◽  
Jaideep Menon ◽  
Jammy Guru Rajesh ◽  
Amitava Banerjee
Keyword(s):  
Economic Burden ◽  
Premature Mortality ◽  
Secondary Outcome ◽  
Years Of Life Lost ◽  
Disability Adjusted Life Years ◽  
Model Based ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Impact ◽  
Model Based Analysis

ObjectivesFrom the beginning of the COVID-19 pandemic, clinical practice and research globally have centred on the prevention of transmission and treatment of the disease. The pandemic has had a huge impact on the economy and stressed healthcare systems worldwide. The present study estimates disability-adjusted life years (DALYs), years of potential productive life lost (YPPLL) and cost of productivity lost (CPL) due to premature mortality and absenteeism secondary to COVID-19 in the state of Kerala, India.SettingDetails on sociodemographics, incidence, death, quarantine, recovery time, etc were derived from public sources and the Collective for Open Data Distribution-Keralam. The working proportion for 5-year age–gender cohorts and the corresponding life expectancy were obtained from the 2011 Census of India.Primary and secondary outcome measuresThe impact of the disease was computed through model-based analysis on various age–gender cohorts. Sensitivity analysis was conducted by adjusting six variables across 21 scenarios. We present two estimates, one until 15 November 2020 and later updated to 10 June 2021.ResultsSeverity of infection and mortality were higher among the older cohorts, with men being more susceptible than women in most subgroups. DALYs for males and females were 15 954.5 and 8638.4 until 15 November 2020, and 83 853.0 and 56 628.3 until 10 June 2021. The corresponding YPPLL were 1323.57 and 612.31 until 15 November 2020, and 6993.04 and 3811.57 until 10 June 2021, and the CPL (premature mortality) were 263 780 579.94 and 41 836 001.82 until 15 November 2020, and 1 419 557 903.76 and 278 275 495.29 until 10 June 2021.ConclusionsMost of the COVID-19 burden was contributed by years of life lost. Losses due to YPPLL were reduced as the impact of COVID-19 infection was lesser among the productive cohorts. The CPL values for individuals aged 40–49 years old were the highest. These estimates provide the data necessary for policymakers to work on reducing the economic burden of COVID-19 in Kerala.

scholarly journals Indirect costs of depression and other mental and behavioural disorders for Australia from 2015 to 2030

BJPsych Open ◽  
2019 ◽  
Vol 5 (3) ◽  
Author(s):  
Deborah Schofield ◽  
Michelle Cunich ◽  
Rupendra Shrestha ◽  
Robert Tanton ◽  
Lennert Veerman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Disorders ◽  
Indirect Costs ◽  
Well Being ◽  
Life Years ◽  
The Government ◽  
Disease Study ◽  
The Impact

BackgroundThe impact of mental disorders has been assessed in relation to longevity and quality of life; however, mental disorders also have an impact on productive life-years (PLYs).AimsTo quantify the long-term costs of Australians aged 45–64 having lost PLYs because of mental disorders.MethodThe Survey of Disability, Ageing and Carers 2003, 2009 formed the base population of Health&WealthMOD2030 – a microsimulation model integrating output from the Static Incomes Model, the Australian Population and Policy Simulation Model, the Treasury and the Australian Burden of Disease Study.ResultsFor depression, individuals incurred a loss of AU$1062 million in income in 2015, projected to increase to AU$1539 million in 2030 (45% increase). The government is projected to incur costs comprising a 22% increase in social security payments and a 45% increase in lost taxes as a result of depression through its impact on PLYs.ConclusionsEffectiveness of mental health programmes should be judged not only in terms of healthcare use but also quality of life and economic well-being.Declaration of interestNone.

scholarly journals Estimation of economic burden of COVID-19 using Disability-Adjusted Life Years (DALYs) and Productivity Losses in Kerala state, India

2021 ◽  
Author(s):  
Denny John ◽  
Narassima MS ◽  
Jaideep C Menon ◽  
Guru Rajesh Jammy ◽  
Amitava Banerjee
Keyword(s):  
Economic Burden ◽  
Age Groups ◽  
Premature Mortality ◽  
Baseline Scenario ◽  
Disability Adjusted Life Years ◽  
Male And Female ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Kerala State ◽  
The Impact

Abstract Background: From the beginning of the COVID-19 pandemic, clinical practice and research, globally, have centered on prevention of transmission and treatment of the disease. The pandemic has had a huge impact on the global economy and stressed the health care systems worldwide.Methods: The present study estimates Disability-Adjusted Life Years (DALYs), Years of Potential Productive Life Lost (YPPLL) and Cost of Productivity Lost (CPL) due to premature mortality and absenteeism, secondary to COVID-19 in Kerala state, India. Details on sociodemography, incidence, death, quarantine, per capita income etc were dervived from various public sources. 5-year age-gender population, working population in each age-gender cohort and corresponding life expectancies were obtained from Census of India 2011. Data on incidence and recovery time were dervied from CODD-K. Details of deaths were extracted from government sources and CODD-K. The impact of disease on various age-gender cohorts has been analyzed. Sensitivity Analysis has been conducted by adjusting six variables with a total of 21 scenarios.Results: Severity of infection and mortality were higher among older sub-group of patients, and male were more susceptible than female in most of the age groups. DALYs for the baseline scenario was 15,924.24 and 8,669.32 for male and female respectively. Total YPPLL for male and female cohorts were estimated to be 1323.57 and 612.31 respectively. People of 40-49 years age constituted 51.34% and 41.76% of the total CPL values (for premature mortality) of males and females respectively.Conclusion: Most of the disease burden from COVID-19 was contributed by YLL. Losses due to YPPLL was reduced as the impact of COVID-19 infection was relatively lesser among the productive age groups. CPL values for people aged from 40-49 years were the highest. These estimates put emphasis that the decision-makers should focus and make efforts on reducing the economic burden for the longer impact of COVID-19 in Kerala state.

scholarly journals Estimation of the economic burden of COVID-19 using Disability-Adjusted Life Years (DALYs) and Productivity Losses in Kerala, India

2021 ◽  
Author(s):  
Denny John ◽  
Narassima MS ◽  
Jaideep C Menon ◽  
Guru Rajesh Jammy ◽  
Amitava Banerjee
Keyword(s):  
Economic Burden ◽  
Health Care Systems ◽  
Premature Mortality ◽  
Secondary Outcome ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Care Systems ◽  
Males And Females ◽  
The Impact

Abstract Objectives: From the beginning of the COVID-19 pandemic, clinical practice and research, globally, have centered on the prevention of transmission and treatment of the disease. The pandemic has had a huge impact on the economy and stressed the health care systems worldwide. The present study estimates Disability-Adjusted Life Years (DALYs), Years of Potential Productive Life Lost (YPPLL), and Cost of Productivity Lost (CPL) due to premature mortality and absenteeism, secondary to COVID-19 in Kerala state, India. Setting: Details on sociodemography, incidence, death, quarantine, recovery time, etc were derived from public sources and CODD-K for Kerala. The working proportion for 5-year age-gender cohorts and corresponding life expectancy were obtained from the Census of India 2011. Primary and secondary outcome measures: The impact of disease on various age-gender cohorts have been analyzed. Sensitivity Analysis has been conducted by adjusting six variables across 21 scenarios. In addition, the estimates have been updated till June 10, 2021. Results: Severity of infection and mortality were higher among the older cohorts, with males being more susceptible than females in most sub-groups. The DALYs for males and females were 15954.5 and 8638.4 till November 15, 2020, and 83853.0 and 56628.3 till June 10, 2021. The corresponding YPPLL were 1323.57 and 612.31 till November 15, 2020, and 6993.04 and 3811.57 till June 10, 2021. CPL (premature mortality) for males and females were 263780579.94 and 41836001.82 till November 15, 2020, and 1419557903.76 and 278275495.29 till June 10, 2021. Conclusions: Most of the COVID-19 disease burden was contributed by YLL. Losses due to YPPLL were reduced as the impact of COVID-19 infection was relatively lesser among productive cohorts. CPL values for 40-49 year-olds were the highest. . These estimates provide the figures and data necessary to policymakers to work on, in order to reduce the economic burden of COVID-19 in Kerala.

scholarly journals Estimation of the economic burden of COVID-19 using Disability-Adjusted Life Years (DALYs) and Productivity Losses in Kerala, India: A model based analysis

2021 ◽  
Author(s):  
Denny John ◽  
M.S. Narassima ◽  
Jaideep C Menon ◽  
Guru Rajesh Jammy ◽  
Amitava Banerjee
Keyword(s):  
Economic Burden ◽  
Premature Mortality ◽  
Secondary Outcome ◽  
Disability Adjusted Life Years ◽  
Model Based ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Kerala State ◽  
The Impact ◽  
Model Based Analysis

Abstract Objectives: From the beginning of the COVID-19 pandemic, clinical practice and research, globally, have centered on the prevention of transmission and treatment of the disease. The pandemic has had a huge impact on the economy and stressed the healthcare systems worldwide. The present study estimates Disability-Adjusted Life Years (DALYs), Years of Potential Productive Life Lost (YPPLL), and Cost of Productivity Lost (CPL) due to premature mortality and absenteeism, secondary to COVID-19 in Kerala state, India. Setting: Details on sociodemography, incidence, death, quarantine, recovery time, etc were derived from public sources and CODD-K for Kerala. The working proportion for 5-year age-gender cohorts and corresponding life expectancy were obtained from the Census of India 2011. Primary and secondary outcome measures: The impact of disease was computed through model based analysis on various age-gender cohorts. Sensitivity Analysis has been conducted by adjusting six variables across 21 scenarios. We present two estimates, one till November 15, 2020, and later updated till June 10, 2021. Results: Severity of infection and mortality were higher among the older cohorts, with males being more susceptible than females in most sub-groups. The DALYs for males and females were 15954.5 and 8638.4 till November 15, 2020, and 83853.0 and 56628.3 till June 10, 2021. The corresponding YPPLL were 1323.57 and 612.31 till November 15, 2020, and 6993.04 and 3811.57 till June 10, 2021 and CPL (premature mortality) were 263780579.94 and 41836001.82 till November 15, 2020, and 1419557903.76 and 278275495.29 till June 10, 2021. Conclusions: Most of the COVID-19 disease burden was contributed by YLL. Losses due to YPPLL were reduced as the impact of COVID-19 infection was lesser among productive cohorts. CPL values for 40-49 year-olds were the highest. These estimates provide the data necessary for policymakers to work on, to reduce the economic burden of COVID-19 in Kerala.Article summaryStrengths and limitations of this study- The first study to characterize the economic burden caused by COVID-19 in Kerala state using DALYs, YPPLL, and CPL- Use of public sourced data for analysis and presentation of results- Exclusion of incidence of case post August 20, 2020, due to unavailability of data could lead to an underestimation of DALYs- Psychological impacts of the mitigation strategies (e.g., lockdown, travel restrictions, etc.) that could increase mortality were not included in the scope- Unpaid work and presenteeism data, and data on post-recovery illness and long-term effects of COVID-19 have not been considered.

scholarly journals Potential impact of a modest reduction in salt intake on blood pressure, cardiovascular disease burden and premature mortality: a modelling study

Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e000943 ◽  
Author(s):  
Leopold Ndemnge Aminde ◽  
Linda J Cobiac ◽  
J Lennert Veerman
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Salt Intake ◽  
Sodium Intake ◽  
Premature Mortality ◽  
Relative Reduction ◽  
Life Years ◽  
Potential Impact ◽  
The Impact

ObjectiveTo assess the potential impact of reduction in salt intake on the burden of cardiovascular disease (CVD) and premature mortality in Cameroon.MethodsUsing a multicohort proportional multistate life table model with Markov process, we modelled the impact of WHO’s recommended 30% relative reduction in population-wide sodium intake on the CVD burden for Cameroonian adults alive in 2016. Deterministic and probabilistic sensitivity analyses were conducted and used to quantify uncertainty.ResultsOver the lifetime, incidence is predicted to decrease by 5.2% (95% uncertainty interval (UI) 4.6 to 5.7) for ischaemic heart disease (IHD), 6.6% (95% UI 5.9 to 7.4) for haemorrhagic strokes, 4.8% (95% UI 4.2 to 5.4) for ischaemic strokes and 12.9% (95% UI 12.4 to 13.5) for hypertensive heart disease (HHD). Mortality over the lifetime is projected to reduce by 5.1% (95% UI 4.5 to 5.6) for IHD, by 6.9% (95% UI 6.1 to 7.7) for haemorrhagic stroke, by 4.5% (95% UI 4.0 to 5.1) for ischaemic stroke and by 13.3% (95% UI 12.9 to 13.7) for HHD. About 776 400 (95% UI 712 600 to 841 200) health-adjusted life years could be gained, and life expectancy might increase by 0.23 years and 0.20 years for men and women, respectively. A projected 16.8% change (reduction) between 2016 and 2030 in probability of premature mortality due to CVD would occur if population salt reduction recommended by WHO is attained.ConclusionAchieving the 30% reduction in sodium intake recommended by WHO could considerably decrease the burden of CVD. Targeting blood pressure via decreasing population salt intake could translate in significant reductions in premature CVD mortality in Cameroon by 2030.

scholarly journals The non-fatal burden of cancer in Belgium, 2004–2018

2021 ◽  
Author(s):  
Vanessa Gorasso ◽  
Geert Silversmit ◽  
Marc Arbyn ◽  
Astrid Cornez ◽  
Robby De Pauw ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Burden Of Disease ◽  
Quality Data ◽  
Years Of Life Lost ◽  
Non Melanoma Skin Cancer ◽  
Life Years ◽  
National Burden ◽  
Disease Study ◽  
The Impact ◽  
Melanoma Skin

Abstract Background The importance of assessing and monitoring the health status of a population has grown in the last decades. Consistent and high quality data on the morbidity and mortality impact of a disease represent the key element for this assessment. Being increasingly used in global and national burden of diseases (BoD) studies, the Disability-Adjusted Life Year (DALY) is an indicator that combines healthy life years lost due to living with disease (Years Lived with Disability; YLD) and due to dying prematurely (Years of Life Lost; YLL). As a step towards a comprehensive national burden of disease study, this study aims to estimate the non-fatal burden of cancer in Belgium using national data. Methods We estimated the Belgian cancer burden from 2004 to 2018 in terms of YLD, using national population-based cancer registry data and international disease models. We developed a microsimulation model to translate incidence- into prevalence-based estimates, and used expert elicitation to integrate the long-term impact of increased disability due to surgical treatment. Results The age-standardized non-fatal burden of cancer increased from 2004 to 2018 by 6% and 2% respectively for incidence- and prevalence-based YLDs. In 2018, in Belgium, breast cancer had the highest morbidity impact among women, followed by colorectal and non-melanoma skin cancer. Among men, prostate cancer had the highest morbidity impact, followed by colorectal and non-melanoma skin cancer. Between 2004 and 2018, non-melanoma skin cancer significantly increased for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 48 to 107 for men and from 15 to 37 for women. Important decreases were seen for colorectal cancer for both sexes in terms of age-standardized incidence-based YLD per 100,000, from 104 to 85 for men and from 52 to 46 for women. Conclusions Breast and prostate cancers represent the greatest proportion of cancer morbidity, while for both sexes the morbidity burden of skin cancer has shown an important increase from 2004 onwards. Integrating the current study in the Belgian national burden of disease study will allow monitoring of the burden of cancer over time, highlighting new trends and assessing the impact of public health policies.

scholarly journals Slaying little dragons: the impact of the Guinea Worm Eradication Program on dracunculiasis disability averted from 1990 to 2016

2018 ◽  
Vol 2 ◽  
pp. 30 ◽  
Author(s):  
Elizabeth A. Cromwell ◽  
Sharon Roy ◽  
Dieudonne P. Sankara ◽  
Adam Weiss ◽  
Jeffrey Stanaway ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Case Reports ◽  
Annual Number ◽  
Infection Prevalence ◽  
Eradication Program ◽  
Guinea Worm ◽  
Disability Weights ◽  
Life Years ◽  
Disease Study ◽  
The Impact

Background:The objective of this study was to document the worldwide decline of dracunculiasis (Guinea worm disease, GWD) burden, expressed as disability-adjusted life years (DALYs), from 1990 to 2016, as estimated in the Global Burden of Disease study 2016 (GBD 2016). While the annual number of cases of GWD have been consistently reported by WHO since the 1990s, the burden of disability due to GWD has not previously been quantified in GBD.Methods:The incidence of GWD was modeled for each endemic country using annual national case reports. A literature search was conducted to characterize the presentation of GWD, translate the clinical symptoms into health sequelae, and then assign an average duration to the infection. Prevalence measures by sequelae were multiplied by disability weights to estimate DALYs.Results:The total DALYs attributed to GWD across all endemic countries (n=21) in 1990 was 50,725 (95% UI: 35,265–69,197) and decreased to 0.9 (95% UI: 0.5–1.4) in 2016. A cumulative total of 12,900 DALYs were attributable to GWD from 1990 to 2016.Conclusions:Using 1990 estimates of burden propagated forward, this analysis suggests that between 990,000 to 1.9 million DALYs have been averted as a result of the eradication program over the past 27 years.

Reducing future air pollution-related premature mortality over Europe by mitigating emissions: assessing an 80 % renewable energies scenario

2021 ◽  
Author(s):  
Patricia Tarín-Carrasco ◽  
Ulas Im ◽  
Camilla Geels ◽  
Laura Palacios-Peña ◽  
Pedro Jiménez-Guerrero
Keyword(s):  
Air Pollution ◽  
Fine Particles ◽  
Respiratory Infections ◽  
Premature Mortality ◽  
Mortality Rates ◽  
European Population ◽  
Chronic Obstructive ◽  
Future Scenarios ◽  
Mitigation Scenario ◽  
The Impact

Abstract. Worldwide air quality has worsened in the last decades as a consequence of increased anthropogenic emissions, in particular from the sector of power generation. The evidence of the effects of atmospheric pollution (and particularly fine particulate matter, PM2.5) on human health is unquestionable nowadays, producing mainly cardiovascular and respiratory diseases, morbidity and even mortality. These effects can even enhance in the future as a consequence of climate penalties and future changes in the population projected. Because of all these reasons, the main objective of this contribution is the estimation of annual excess premature deaths (PD) associated to PM2.5 on present (1991–2010) and future (2031–2050) European population by using non-linear exposure-response functions. The endpoints included are Lung Cancer (LC), Chronic Obstructive Pulmonary Disease (COPD), Low Respiratory Infections (LRI), Ischemic Heart Disease (IHD), cerebrovascular disease (CEV) and other Non-Communicable Diseases (other NCD). PM2.5 concentrations come from coupled chemistry-climate regional simulations under present and RCP8.5 future scenarios. The cases assessed include the estimation of the present incidence of PD (PRE-P2010), the quantification of the role of a changing climate on PD (FUT-P2010) and the importance of changes in the population projected for the year 2050 on the incidence of excess PD (FUT-P2050). Two additional cases (REN80-P2010 and REN80-P2050) evaluate the impact on premature mortality rates of a mitigation scenario in which the 80 % of European energy production comes from renewables sources. The results indicate that PM2.5 accounts for nearly 895,000 [95 % confidence interval (95 % CI) 725,000-1,056,000] annual excess PD over Europe, with IHD being the largest contributor to premature mortality associated to fine particles in both present and future scenarios. The case isolating the effects of climate penalty (FUT-P2010) estimates a variation +0.2 % on mortality rates over the whole domain. However, under this scenario the incidence of PD over central Europe will benefit from a decrease of PM2.5 (−2.2 PD/100,000 h.) while in eastern (+1.3 PD/100,000 h.) and western (+0.4 PD/100,000 h.) Europe PD will increase due to increased PM2.5 levels. The changes in the projected population (FUT-P2050) will lead to a large increase of annual excess PD (1,540,000, 95 % CI 1,247,000-1,818,000), +71.96 % with respect to PRE-P2010 and +71.67 % to FUT-P2010) due to the aging of the European population. Last, the mitigation scenario (REN80-P2050) demonstrates that the effects of a mitigation policy increasing the ratio of renewable sources in the energy mix energy could lead to a decrease of over 60,000 (95 % CI 48,500-70,900) annual PD for the year 2050 (a decrease of −4 % in comparison with the no-mitigation scenario, FUT-P2050). In spite of the uncertainties inherent to future estimations, this contribution reveals the need of the governments and public entities to take action and bet for air pollution mitigation policies.

scholarly journals Indirect costs associated with ulcerative colitis: a systematic literature review of real-world data

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Joelle Constantin ◽  
Petar Atanasov ◽  
Daniel Wirth ◽  
Andras Borsi
Keyword(s):  
Ulcerative Colitis ◽  
Sick Leave ◽  
Indirect Costs ◽  
Cochrane Library ◽  
Real World Data ◽  
Eligibility Criteria ◽  
Productivity Costs ◽  
Productivity Losses ◽  
The Impact

Abstract Background The economic burden of ulcerative colitis (UC), specifically related to indirect costs, is not extensively documented. Understanding and quantifying it is required by health care decision makers. Aim To assess the impact of indirect costs of UC in observation studies. Method A systematic literature search was conducted in MEDLINE®, Embase® and Cochrane Library to capture all relevant publications reporting outcomes on absenteeism, presenteeism and productivity losses in moderate to severe UC. Eligibility criteria for inclusion into the review were established using a predefined PICOS scheme. All costs were adjusted to 2017 currency values (USD dollars, $). Results In total, 18 studies reporting data on indirect costs were included in the analysis. Absenteeism costs were classified into three categories: sick leave, short-term and long-term disability. Most of the studies captured absenteeism costs related specifically to sick leave, which was experienced on average by 10 to 24% patients with UC. Only three studies captured presenteeism costs, as these are difficult to measure, however costs ranged from 1602 $ to 2947 $ per patient year. The proportion of indirect costs accounted for 35% of total UC costs (Total UC costs were defined as the sum of healthcare costs, productivity costs and out-of-pocket costs). Discussion A limited number of studies were identified describing the indirect costs in patients with moderate to severe UC. Insufficient data on different components of costs allowed a limited analysis on the impact of indirect costs in patients with UC. Further studies are needed to gain an understanding of the influence of UC on patients’ functional abilities.

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