SUN-296 Acromegaly Significantly Impacts Employees’ Health Benefit Costs and Increases Work Absenteeism
Authors: Yuen Kevin C j , Munoz Kathryn A , Brook Richard Alan , Whalen John D , Beren Ian A , Ribeiro-Oliveira Antonio 
Published: May 2020

Abstract
Background: Acromegaly (ACRO) is a rare, chronic disorder of growth hormone hypersecretion associated with increased morbidity that can affect work productivity. Data on ACRO employees’ health costs and work absenteeism are limited.
Aims: To assess the impact of ACRO on employees’ health benefit costs and absenteeism.
Methods: A US employee database of prescription (Rx) drug, medical claims, and absenteeism (payment and time) from Jan 2010 to Apr 2019 was analyzed. Employees with the diagnosis (Dx) of ACRO were identified based on claims with ICD-9/-10 codes 253.0x/E22.0. A 12 month study period followed each employee’s first ACRO Dx in the database (the index date). ACRO patients in the study had ≥ 2 ACRO Dxs &gt; 30 days apart, or 1 ACRO Dx plus either a pituitary adenoma Dx or a pituitary surgery or radiosurgery claim during the study period. Controls were matched to each ACRO employee on demographic, job-related variables, region, and Charlson comorbidity index (CCI) score. Costs were adjusted using the general Consumer Price Index (CPI), medical CPI, and Rx cost CPI. Outcomes included direct costs (medical and Rx), indirect costs (absence payments by benefit type), and lost time (absences by benefit type). Outcomes were analyzed using two-part regression models (logistic followed by generalized linear) for each outcome, controlling for demographic and job-related variables, region, and CCI scores. Data are shown as likelihood or mean ± standard error. Findings are significant at P &lt; 0.05.
Results: Participants were 18–65 yr old with continuous eligibility for medical and Rx benefits for the study period. Forty seven ACRO patients and 940 controls were identified. ACRO employees were similar to the controls in most demographic (age, gender, race) and job-related variables (tenure, full-/part-time status, exempt status, salary), but had a higher CCI (0.60 ± 0.15 vs 0.30 ± 0.03; P = 0.029) and a higher incidence of chronic lung disease (31.9 vs 17.4%; P = 0.012), hyperlipidemia (27.7 vs 16.0%, P = 0.035), arthritis (19.1 vs 3.7%), diabetes (31.9 vs 8.3%), hypertension (40.4 vs 13.6%), and thyroid disease (31.9 vs 8.9%) (P &lt; 0.0001). Patients with ACRO were 64.3% more likely to have undergone an MRI (P &lt; 0.0001).Total indirect costs (including sick leave and disability) were higher for ACRO patients ($10,530 vs $1,157; P &lt; 0.05) with both short-term and long-term disability comprising 96% of the difference. Compared with employees without ACRO, employees with ACRO used more short-term disability (10.9 vs 0.9 days; P = 0.0076) and had more total days absent from work (12.7 vs 3.3 days; P &lt; 0.05).
Conclusions: Our findings indicate that ACRO has far-reaching implications on direct and indirect employee health benefit costs and increased work absenteeism. Awareness by employers of ACRO-induced increased absenteeism is important to tailor working conditions and to prevent unrealistic work expectations.