Hard to swallow

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A little pill can have a big effect on worker absenteeism, according to a new study from UGA’s Terry College of Business. When a popular pain reliever was taken off the market, the negative consequences for absenteeism were greater than the benefits of the drug while it was on the market.

The finding is from a study that analyzed the labor market effects of Vioxx, a joint pain medication that was introduced in the U.S. in 1999 and in Europe in the early 2000s and then removed from pharmacy shelves in 2004, after studies showed that it may cause an increased risk of heart attack and stroke.

The introduction and withdrawal of Vioxx, which was commonly prescribed for conditions like arthritis, created a natural laboratory for economists Meghan Skira of the Terry College and Aline Bütikofer of the Norwegian School of Economics to study its effects on the labor supply of individuals with joint pain. The researchers based their analysis on administrative data from Norway on sickness absence and disability pension receipt for the analysis.

“We found that when Vioxx entered the market, it decreased quarterly sickness absence days among individuals with joint pain by 7 to 12 percent,” Skira says.

But when the drug ceased to be available, she says, those gains were entirely erased—and absenteeism and disability claims actually rose above their levels before Vioxx had been introduced.

“The withdrawal of Vioxx from the pharmaceutical market increased sickness absence days by 12 to 16 percent and increased the quarterly probability of receiving disability benefits by 6 to 15 percent compared to the years before Vioxx’s entry.”

The economic consequences of taking Vioxx off the market were substantial for workers and their employers—an effect that Skira says has compelling implications both for the drug approval process and for the decision to take a pharmaceutical off the market. The study, published in the Journal of Human Resources, also emphasizes the importance of weighing economic factors when determining the net benefits of advances in medical technologies and pharmaceuticals.

“Considering labor supply effects and not just focusing on clinical outcomes and medical costs has potentially significant implications for regulatory decision-making and the coverage and reimbursement policies of insurance plans and national health care systems,” Skira says.

While both men and women suffer from joint pain, Vioxx’s removal from the market had a larger impact on women’s sickness absence, the study found.

“This is consistent with other studies that find gender differences in absenteeism,” Skira says. “While we can’t say for certain what causes these differences, it may be due to what studies call the ‘double burden’ and the gender division of household work. The idea is that women are more exposed to the ‘double burden’ of combining work with family obligations, which may affect their ability to cope with negative health shocks.”

This story appeared in the spring 2018 issue of Research Magazine. The original press release is available at https://news.uga.edu/work-absenteeism-drugs-leave-market/.