Abstract：
Productivity loss may contribute to a large proportion of costs of health conditions in an economic evaluation from a societal perspective, but there is currently a lack of methodological consensus on how productivity loss should be measured and valued. Despite the research progress surrounding this issue in other countries, it has been rarely discussed in China.
We reviewed the official guidelines on economic evaluations in different countries and regions and screened the literature to summarise the extent to which productivity loss was incorporated in economic evaluations and the underlying methodological challenges.
A total of 48 guidelines from 46 countries/regions were included. Although 32 (67%) guidelines recommend excluding productivity loss in the base case analysis, 23 (48%) guidelines recommend including productivity loss in the base case or additional analyses. Through a review of systematic reviews and the economic evaluation studies included in these reviews, we found that the average probability of incorporating productivity loss in an economic evaluation was 10.2%. Among the economic evaluations (n=478) that explicitly considered productivity loss, most (n=455) considered losses from paid work, while only a few studies (n=23) considered unpaid work losses. Recognising the existing methodological challenges and the specific context of China, we proposed a practical research agenda and a disease list for progress on this topic, including the development of the disease list comprehensively consisting of health conditions where the productivity loss should be incorporated into economic evaluations.
An increasing number of guidelines recommend the inclusion of productivity loss in the base case or additional analyses of economic evaluation. We optimistically expect that more Chinese researchers notice the importance of incorporating productivity loss in economic evaluations and anticipate guidelines that may be suitable for Chinese practitioners and decision-makers that facilitate the advancement of research on productivity loss measurement and valuation.
We reviewed the official guidelines on economic evaluations in different countries and regions and screened the literature to summarise the extent to which productivity loss was incorporated in economic evaluations and the underlying methodological challenges.
A total of 48 guidelines from 46 countries/regions were included. Although 32 (67%) guidelines recommend excluding productivity loss in the base case analysis, 23 (48%) guidelines recommend including productivity loss in the base case or additional analyses. Through a review of systematic reviews and the economic evaluation studies included in these reviews, we found that the average probability of incorporating productivity loss in an economic evaluation was 10.2%. Among the economic evaluations (n=478) that explicitly considered productivity loss, most (n=455) considered losses from paid work, while only a few studies (n=23) considered unpaid work losses. Recognising the existing methodological challenges and the specific context of China, we proposed a practical research agenda and a disease list for progress on this topic, including the development of the disease list comprehensively consisting of health conditions where the productivity loss should be incorporated into economic evaluations.
An increasing number of guidelines recommend the inclusion of productivity loss in the base case or additional analyses of economic evaluation. We optimistically expect that more Chinese researchers notice the importance of incorporating productivity loss in economic evaluations and anticipate guidelines that may be suitable for Chinese practitioners and decision-makers that facilitate the advancement of research on productivity loss measurement and valuation.
摘要：
从社会角度来看，在经济评估中，生产力损失可能会导致健康状况成本的很大一部分。但是目前在如何衡量和评估生产率损失方面缺乏方法论共识。尽管其他国家围绕这个问题的研究进展，在中国很少讨论。
我们回顾了不同国家和地区关于经济评估的官方指南，并筛选了文献，以总结生产率损失被纳入经济评估的程度和潜在的方法论挑战。
共纳入了来自46个国家/地区的48条指南。尽管32(67%)指南建议在基本情况分析中排除生产率损失，23(48%)指南建议在基本情况或额外分析中包括生产力损失。通过对系统综述和这些综述所包含的经济评价研究的综述,我们发现，将生产率损失纳入经济评估的平均概率为10.2％。在明确考虑生产率损失的经济评估(n=478)中，大多数(n=455)考虑了有偿工作的损失，而只有少数研究(n=23)考虑了无偿工作损失。认识到现有的方法论挑战和中国的具体情况，我们提出了一个切实可行的研究议程和疾病清单，包括制定全面包括健康状况的疾病清单，其中生产力损失应纳入经济评估。
越来越多的指南建议将生产率损失纳入基本情况或进行额外的经济评估分析。我们乐观地期望更多的中国研究人员注意到将生产率损失纳入经济评估的重要性，并预期可能适合中国从业者和决策者的指导方针，以促进生产率损失测量和估值研究的发展。
我们回顾了不同国家和地区关于经济评估的官方指南，并筛选了文献，以总结生产率损失被纳入经济评估的程度和潜在的方法论挑战。
共纳入了来自46个国家/地区的48条指南。尽管32(67%)指南建议在基本情况分析中排除生产率损失，23(48%)指南建议在基本情况或额外分析中包括生产力损失。通过对系统综述和这些综述所包含的经济评价研究的综述,我们发现，将生产率损失纳入经济评估的平均概率为10.2％。在明确考虑生产率损失的经济评估(n=478)中，大多数(n=455)考虑了有偿工作的损失，而只有少数研究(n=23)考虑了无偿工作损失。认识到现有的方法论挑战和中国的具体情况，我们提出了一个切实可行的研究议程和疾病清单，包括制定全面包括健康状况的疾病清单，其中生产力损失应纳入经济评估。
越来越多的指南建议将生产率损失纳入基本情况或进行额外的经济评估分析。我们乐观地期望更多的中国研究人员注意到将生产率损失纳入经济评估的重要性，并预期可能适合中国从业者和决策者的指导方针，以促进生产率损失测量和估值研究的发展。
