POSB138 Medication Adherence Impacts Lost Time, Productivity Costs and Emergency Room Visits in Employees with Diabetes

To explore the impact of medication adherence on absences, productivity costs and emergency room (ER) visits on employees with Type 2 Diabetes (Diabetes). The Workpartners Research Reference Database (RRDb) includes direct components (medical and prescription claims), indirect components (sick-leave/paid time-off, short-term disability, family medical leaves [FMLA]), demographic, job-related information and self-reported survey data. A subset of 10 employer groups (377,485 employees) was selected from the database. Employees with diabetes were identified using ICD-10 codes in claims (January-2017—December-2019) and were required to have ≥1 year continuous data following their initial disease claim. The proportion of days covered (PDC) for oral and self-injected antidiabetic medications was calculated and employees assigned into quartiles (25%) as low (lowest quartile), high (highest quartile), or moderate (middle quartiles) adherence. Low adherence employees were matched to high adherence employees on age and gender. Outcomes were evaluated over the study year and compared payments/hours missed for: disability, FMLA, workers’ compensation, absences (sick-leave/paid time-off) and total. Regression models were used to predict the annual avoidable absence costs (by category and in total) and the number of avoidable ER visits. Results projected using employee salaries of $50,000—$100,000. Findings significant †P≤0.01,‡P≤0.0001. Overall, 11,602 employees were identified with diabetes with low adherence (PDC ≤ 49.3%) and high-adherence (PDC ≥ 95.9%). Compared to employees with high adherence, employees with low adherence with diabetes annually missed 83 additional-hours due to: short-term FMLA-leaves (25.4 hours†), workers’ compensation (7.6 hours), and sick-leave/paid time-off (29.6 hours‡). Total avoidable absence costs were estimated to be $2—$4million and 83 avoidable ER visits. Poor medication adherence correlates to increased lost time, productivity costs, and avoidable ER visits in employees with diabetes. Results are being used to pilot adherence intervention programs and quantify the impact on lost time, absence costs, ER visits, and medical events.