Zanfina Ademi, Dina Abushanab, Maria J Alfonso Arvez, Clara Marquina, Karl Vivoda, Janne Martikainen, Piia Lavikainen, Melanie Lloyd, Danny Liew
{"title":"Scoping Review of Productivity-Adjusted Life Years (PALYs): Methods, Applications and Policy Implications.","authors":"Zanfina Ademi, Dina Abushanab, Maria J Alfonso Arvez, Clara Marquina, Karl Vivoda, Janne Martikainen, Piia Lavikainen, Melanie Lloyd, Danny Liew","doi":"10.1007/s40273-025-01544-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To understand the application of productivity-adjusted life years (PALYs) as an outcome measure across various disease contexts.</p><p><strong>Methods: </strong>We conducted a scoping review of studies published between 2018 and April 2025 that utilised PALYs to illustrate their potential applications and identify methodological approaches that have been applied. Using a citation-based search, we selected studies that applied PALYs to quantify societal health burdens in specific diseases or contexts. Extracted data included health conditions, country, timeframe, model type, outcomes, productivity index components, gross domestic product and sensitivity analysis. Findings were summarised through narrative synthesis.</p><p><strong>Results: </strong>A total of 41 studies conducted between 2018 and 2025 were reviewed, including chronic diseases such as diabetes and cardiovascular diseases, as well as environmental factors. Conditions such as breast cancer, leukaemia, kidney disease, mental health, knee osteoarthritis, epilepsy and sleep apnoea had the lowest productivity indices. Most of these studies originated from high-income countries (n = 27), followed by upper-middle-income (n = 10), and lower-middle-income (n = 4) settings. Life table models were the most common methodological approach adopted (n = 26), followed by dynamic models (n = 10). Studies focused on disease prevention (n = 21) outnumbered those addressing disease management (n = 18). Most studies accounted for both absenteeism and presenteeism (n = 30). Estimates of productivity loss per person using gross domestic product ranged from US$1137 to AU$217,983 annually.</p><p><strong>Conclusions: </strong>PALYs have been utilised in diverse diseases and contexts, highlighting their utility in measuring societal health impacts. However, adding unpaid and informal work makes burden estimates more accurate. The increasing emphasis on prevention indicates a strategic change in health policy and economic assessment.</p>","PeriodicalId":19807,"journal":{"name":"PharmacoEconomics","volume":" ","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"PharmacoEconomics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40273-025-01544-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ECONOMICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To understand the application of productivity-adjusted life years (PALYs) as an outcome measure across various disease contexts.
Methods: We conducted a scoping review of studies published between 2018 and April 2025 that utilised PALYs to illustrate their potential applications and identify methodological approaches that have been applied. Using a citation-based search, we selected studies that applied PALYs to quantify societal health burdens in specific diseases or contexts. Extracted data included health conditions, country, timeframe, model type, outcomes, productivity index components, gross domestic product and sensitivity analysis. Findings were summarised through narrative synthesis.
Results: A total of 41 studies conducted between 2018 and 2025 were reviewed, including chronic diseases such as diabetes and cardiovascular diseases, as well as environmental factors. Conditions such as breast cancer, leukaemia, kidney disease, mental health, knee osteoarthritis, epilepsy and sleep apnoea had the lowest productivity indices. Most of these studies originated from high-income countries (n = 27), followed by upper-middle-income (n = 10), and lower-middle-income (n = 4) settings. Life table models were the most common methodological approach adopted (n = 26), followed by dynamic models (n = 10). Studies focused on disease prevention (n = 21) outnumbered those addressing disease management (n = 18). Most studies accounted for both absenteeism and presenteeism (n = 30). Estimates of productivity loss per person using gross domestic product ranged from US$1137 to AU$217,983 annually.
Conclusions: PALYs have been utilised in diverse diseases and contexts, highlighting their utility in measuring societal health impacts. However, adding unpaid and informal work makes burden estimates more accurate. The increasing emphasis on prevention indicates a strategic change in health policy and economic assessment.
期刊介绍：
PharmacoEconomics is the benchmark journal for peer-reviewed, authoritative and practical articles on the application of pharmacoeconomics and quality-of-life assessment to optimum drug therapy and health outcomes. An invaluable source of applied pharmacoeconomic original research and educational material for the healthcare decision maker.
PharmacoEconomics is dedicated to the clear communication of complex pharmacoeconomic issues related to patient care and drug utilization.
PharmacoEconomics offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by a Key Points summary, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
