Research review 091
Secondary analysis and economic modelling of randomised trials
Short answer
Participants given fezolinetant reported less work impairment than placebo groups. Researchers then used their answers to calculate work hours and potential economic benefits in seven countries. These are not documented employer savings, and the one-year estimates partly extend shorter follow-up periods.
What did the researchers investigate?
This analysis used work-related questionnaire data from SKYLIGHT 1, SKYLIGHT 2 and DAYLIGHT. Participants reported absence from work and the extent to which hot flushes had affected work during the past seven days. The latter is often called presenteeism: being at work while feeling less able to function.
Answers were combined with external data on employment, working hours and wages. Researchers then calculated possible lost working hours and indirect costs. This step is economic modelling, not a direct measurement of work completed or wage savings.
What did the researchers find?
Reported ability to work was used in a cost model
Fezolinetant groups reported less total productivity loss than placebo groups. Much of the difference concerned perceived ability to function while at work. Differences in absence alone were less clear.
The model translated this into potential additional work hours and lower indirect costs. The amounts varied between countries because wages, working hours and employment differed. A high monetary amount may therefore partly reflect high wages, not a larger medical effect.
One-year estimates were not based on a full year of comparable placebo follow-up in every trial. SKYLIGHT had twelve weeks of placebo, and DAYLIGHT had 24. Later values were largely estimated by carrying forward the last observation.
How certain can we be?
Random allocation in the original trials strengthens comparisons of treatment. However, this secondary analysis selected working participants and used self-reported outcomes. People without employment during the period contributed differently or lacked necessary answers.
Carrying forward the final observation assumes that the pattern would not change substantially afterwards. External average wages also do not describe each participant's employment. The cost estimate does not constitute a complete economic evaluation including all treatment costs and consequences. Modelling choices must therefore be explained whenever an estimated saving is quoted.
Who do the findings apply to?
Two analysis groups contained 359 and 614 working participants. These groups overlap and must not be added together as 973 different people. One group was drawn from SKYLIGHT, the other from participants meeting defined criteria about not using hormone treatment across three trials.
The underlying trials were international. Economic modelling covered the United States, Canada, United Kingdom, Germany, France, Australia and Brazil. Wages and employment data from these countries were applied to trial results. This does not mean each country contributed its own equally large patient population or directly measured economic outcomes.
What might this mean in everyday life?
The study illustrates how symptom relief may matter during working life. It does not justify promising employers a particular financial return or directly transferring the amounts to Norway. Perceived functioning at work is an important outcome, but is distinct from measured production and confirmed reductions in cost.
What do we still need to know?
Work and absence should be tracked for at least one year rather than extrapolating from shorter follow-up. People who reduced working hours or left employment should also be included, or important burdens may be missed.
Researchers should examine total costs, including treatment and follow-up. Only then can the potential economic value of symptom relief be better assessed. A modelled value of saved working time is not the same as confirmed savings.
Sources
The publication examined in this review
Morga A, Tai TA, Kapoor R, Song W, Hua Q, Hua Y, Yang H, Ajmera M. Estimated impact of fezolinetant versus placebo on work productivity and indirect costs among women experiencing vasomotor symptoms associated with menopause. Menopause (New York, N.Y.), 2026.
Other studies and professional sources mentioned in the text
Background source: Efficacy and safety of fezolinetant for moderate-severe vasomotor symptoms associated with menopause in individuals unsuitable for hormone therapy: phase 3b randomised controlled trial. 2024. Read the publication.
Background source: "I did not recognize myself": a mixed methods study to better understand the experiences of menopause in a US workplace. 2025. Read the publication.
Previous reference on the card
Menopausal symptoms and work productivity. Systematic review. Previous source.
Last reviewed: 30 October 2026.
Source basis: The publication's full text.
Editorial update, 1 November 2026: Language, explanations and references were reviewed. The source-review date is stated above.