Myasthenia gravis tied to substantial employment losses in Spain

Myasthenia gravis (MG) is associated with substantial disruptions to employment, with only about half of working-age adults with MG in a Spanish study employed and nearly one-third receiving permanent work disability benefits.

Among participants who reported how MG had affected their employment, more than four in 10 said they had left a job because of the disease.

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Better self-perceived health and higher education were associated with a greater likelihood of being employed, while self-reported refractory, or treatment-resistant, MG was associated with a substantially lower likelihood of employment. Reduced employment was estimated to result in about €4,500 (about $5,250) in lost productivity per person each year.

“The study broadens understanding of the societal burden of myasthenia gravis beyond clinical outcomes,” the researchers wrote, adding that its results “may inform public health, disability, and workplace policies aimed at supporting employment among people with chronic neurological conditions.”

The study, “Employment Status and Labour Productivity Losses Associated with Myasthenia Gravis: An Observational Study,” was published in Archives of Public Health.

MG is a rare, chronic autoimmune disease that causes muscle weakness and fatigue. Because MG symptoms can fluctuate substantially over time, the disease may make it difficult to maintain predictable work schedules and balance employment with medical appointments, treatment, and family responsibilities.

Despite this, few studies have examined the impact of MG on employment and productivity.

With this in mind, a team of researchers collected data through a self-administered online questionnaire given to working-age adults with MG during routine neurology visits across several Spanish centers between October 2023 and February 2024.

Survey captures employment impact across 122 adults with MG

A total of 122 patients completed the questionnaire. Their average age was 49, 42% were women, and they had been living with MG for an average of 8.5 years. Nearly 60% had generalized MG, a form of the disease that affects muscles throughout the body.

More than 90% had a medium or high level of education, and about two-thirds (66.4%) were married or in a relationship. About one in four (25.41%) rated their current health status as bad or very bad.

Nearly all participants (96.52%) had worked at some point, but only 54.92% were employed when surveyed. Nearly one-third (31.2%) were receiving permanent work disability benefits, while 6.56% were unemployed and 7.38% were otherwise outside the workforce.

Among those who reported how MG had affected their employment, 43.24% said they had left a job because of the disease. Another 21.62% said they had made changes at work, reduced their hours, or taken on less responsibility, while 35.14% said MG had not significantly changed their employment situation.

Many participants also reported limited workplace support. Nearly 78% said their working conditions had not been adapted when their disease worsened, and 73.39% felt managers were not at all aware of MG symptoms or how workplace changes could help people remain employed. Only 6.31% said services were available to help people with MG continue working.

MG also created challenges in day-to-day work and career advancement. About 61% reported at least some difficulty getting to work, while more than three-quarters said medical appointments or MG treatment affected their working life to some degree. More than half (54.54%) said MG had considerably or totally affected their chances for promotion.

Participants also reported effects on future employment and their finances. About 69% said MG considerably or totally affected their search for a new job, and nearly 63% reported at least some financial difficulties after MG began. Among those asked about stopping work, nearly three-quarters (73.88%) said giving up work had a major effect on their self-esteem.

Statistical model identifies factors linked to employment

Researchers then used a statistical model to determine which factors were associated with employment. Higher education was associated with a 19.1 percentage-point greater probability of being employed, while reporting good general health was associated with a 34.9 percentage-point greater probability of employment compared with reporting fair or poor health.

In contrast, people who reported having refractory MG had a 43.6 percentage-point lower probability of employment than those who did not report refractory MG. Age was also significantly associated with employment, although the relationship was not linear. No significant difference in the likelihood of being employed was found between men and women.

To estimate lost productivity, the researchers compared 2024 employment rates in the MG sample with those of the general Spanish population, adjusting the comparisons by age group and sex. Across those groups, employment rates among people with MG were about 10.8 to 19.6 percentage points lower.

Those employment differences translated into estimated productivity losses of €549,292 (about $640,570) per year across the 122 participants, or an average of €4,502.40 (about $5,250) per person in 2024. The researchers noted that the estimate reflects losses from reduced employment and does not include absenteeism, reduced productivity while working, or other indirect costs.

Overall, this study shows that “MG is associated with substantial reductions in employment and measurable productivity losses among working-age patients,” the researchers wrote.

The findings point to a need for better disease management, greater workplace awareness and vocational support, and accommodations that account for MG’s fluctuating symptoms and need for frequent medical care, the researchers concluded.