Indirect Costs Related to Productivity Loss, Work-Related Quality of Life, and Resource Utilization in Workers with Multiple Sclerosis

PURPOSE: Multiple sclerosis (MS) often affects individuals during their most productive working years, resulting in reduced work capacity and quality of life. This study aimed to assess work productivity loss, work-related quality of life (WRQoL), and healthcare and social resource utilization among Italian workers with MS and to identify the predictors of productivity-related indirect costs. METHODS: A cross-sectional study was conducted involving 160 employed people with MS (PwMS) in Italy. Work productivity and activity impairment were measured using the Work Productivity and Activity Impairment questionnaire for MS (WPAI:MS), while work-related difficulties were assessed with the MSQ-Job. WRQoL and healthcare and social support utilization were evaluated using validated instruments. Productivity losses were monetized using national wage data. Two-part regression models were applied to identify the predictors of annual indirect costs. RESULTS: Overall, 79.4% of PwMS reported productivity loss, predominantly due to presenteeism (76.9%), with a mean overall work impairment of 40.3%. The mean annual cost of productivity loss was €12,580, 83% of which was attributable to presenteeism. Indirect costs were significantly higher among PwMS reporting work-related difficulties (€13,992 vs €7098; p < 0.001). Lower WRQoL, higher fatigue levels, and greater healthcare needs were associated with increased productivity losses, while higher WRQoL emerged as a protective factor. CONCLUSION: MS-related work impairment generates substantial indirect costs, largely driven by presenteeism. Interventions targeting workplace well-being, fatigue management, and vocational rehabilitation may help reduce productivity losses and improve quality of life among PwMS.