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Insomnia represents potentially large financial liability for employers, research indicates

Wednesday, December 12 2007 | Comments
Evidence Grade 0 What's This?
Employees with insomnia appear to incur higher health benefit costs relative to employees without insomnia, results from a retrospective analysis show.

"Because people with insomnia have a number of comorbities, it's hard to look at the true cost of insomnia," lead researcher Richard Brook, of The JeSTARx Group, told VerusMed.

Using the 2001-06 Human Capital Management Services Research Reference Database, which contains U.S. employer data, as well as medical and payroll records for approximately 510,000 workers, the researchers examined the annual health benefit costs for employees with and without insomnia. They used a regression model and adjusted for age, tenure, sex, marital status, race, work status (exempt vs nonexempt and full-time vs part-time), salary, Charlson Comorbidity Index scores, and geographic location to compare medical and prescription costs (direct costs), as well as payments for sick leave, short- and long-term disability, and workers' compensation claims (indirect costs).

Of the 294,042 individuals who met inclusion criteria for the analysis, 4.19% had received a diagnosis of insomnia or had prescriptions for hypnotics (ie, ramelteon, zaleplon, zolpidem, and eszopiclone).

Average annual costs of health benefits were $6,240 per employee with insomnia compared with $3,015 per employee without insomnia. The results revealed significant differences in costs between the 2 cohorts for all of the direct and indirect costs measured (P<.0001 for all).

Specifically, medical costs were $3,306 for employees with insomnia and $1,749 for those without insomnia, while prescription drug costs were $1,220 and $422, respectively. Annual sick leave costs averaged $720 for workers with insomnia versus $325 for those without insomnia. The respective mean annual costs for short-term disability were $465 versus $229, while long-term disability costs were $46 versus $10, and workers' compensation costs were $483 versus $280.

The researchers further determined that insomnia was associated with an annual average incremental cost of $3,225 per employee. Nearly half of this amount (48.3%) was attributed to direct medical costs other than prescription drugs; the remainder was split between prescription drug costs (24.7%) and indirect costs (27.0%).

Brook told VerusMed that insomnia "is impactful in a number of areas--not just in medical costs, but in terms of absenteeism and presenteeism" and that therapy should be "fine-tuned" to the individual patient. (Poster #0722.)

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