The Impact of Moderate-to-severe Crohn's Disease on Employees' Salary Growth

Background: Moderate-to-severe Crohn's Disease (CD) has been shown to reduce daily activities; however, little is known of the impact on employees' salary growth. Methods: Employment and health care benefit data were extracted from the OptumHealth Reporting and Insights database, aggregating data from 23 self-insured U. S. companies with approximately 2.5 million covered beneficiaries. Employees diagnosed with moderate-to-severe CD (i.e., >= 1 prescription fill for systemic corticosteroids, immunosuppressive drugs, methotrexate or cyclosporine, or biologic agents within 6 months after the first observed CD diagnosis) between January 1999 and December 2006 were retrospectively matched with controls without CD based on year of birth, sex, industry, and geographic region. Employees' salaries and salary growth rates were estimated and compared between cohorts. Both descriptive comparison and multivariate regression analyses controlling for baseline characteristics and differences in comorbidities were performed. Results: A total of 918 employees with moderate-to-severe CD were matched to 2154 CD-free controls. The 2 cohorts did not differ in their annual salary in the first year of observation. However, regression analyses revealed that the 2 groups had significantly different adjusted annualized salary growth rates (0.69% versus 1.01%, P<0.001), and employees with CD had a 31% lower salary increase rate than controls. A total income loss of $3195 per person was estimated for employees with CD compared with their CD-free peers over a cumulative 5 years after the first calendar year. Conclusions: In the United States, employees with moderate-to-severe CD had a substantially lower salary growth rate than their peers without CD, suggesting an impaired career progression.