McBride D, Abuzakouk M, Balp M-M, Berard F, Canonica GW, Gimenez-Arnau A, Grattan C, Hollis K, Khalil S, Knulst A, Lacour J-P, Lynde C, Marsland A, Nakonechna A, Ortiz de Frutoz FJ, Oude Elberink JNG, Proctor C, Sussman G, Weller K, Maurer M. ASSURE-CSU: assessing the impact of chronic spontaneous/idiopathic urticaria on work productivity and activity. Poster presented at the 2016 ISPOR 21st Annual International Meeting; May 23, 2016. Washington, DC. [abstract] Value Health. 2016 May; 19(3):A124-5.

OBJECTIVES: Chronic spontaneous/idiopathic urticaria (CSU), defined as the spontaneous appearance of itchy hives, angioedema, or both for greater than or equal to 6 weeks, has a significant yet underestimated impact on patients' work productivity. The ASSURE-CSU study aimed to identify and quantify the humanistic and economic burden of CSU. We present here data on work productivity and activity impairment.

METHODS: Patients with CSU for greater than or equal to 12 months, aged greater than or equal to 18 years, symptomatic despite treatment were recruited in 7 countries (Canada, France, Germany, Italy, Netherlands, Spain, UK). Data were collected on absenteeism, presenteeism and activity impairment over the previous 7 days via the Work Productivity and Activity Impairment–Specific Health problem (WPAI-SHP) questionnaire. Descriptive statistics were provided and stratified by disease activity, measured by the Urticaria Activity Score (UAS) daily diary, which has a range from 0-42 for the weekly score (UAS7).

RESULTS: 673 patients (72.7% women) were enrolled with a mean age of 48.8 years and 4.8 years mean disease duration since diagnosis. The WPAI was returned by 614 patients, with 341 employed. The mean (SD) proportion of overall activity impairment due to CSU was 32.8% (28.96%). Employed patients reported a mean (SD) proportion of absenteeism, presenteeism and overall work productivity loss of 6.1% (17.83%), 25.2% (25.78%) and 26.9% (27.53%) respectively, with 12.5% of patients reporting over a half-day of work missed in the previous week. Overall, impairment increased with increasing disease activity during the same time period. Specifically, the highest percentages of absenteeism, presenteeism, overall work impairment, and activity impairment were reported by patients with the greatest disease activity (UAS7=28-42) (9.5%, 40.4%, 43.6%, and 52.3%, respectively).

CONCLUSIONS: This analysis from ASSURE-CSU suggests that CSU patients experience substantial activity impairment. Employed patients are affected at work by their disease, through absenteeism and reduced productivity. This overall work impairment results in significant impact for patients, employers and society.