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Real-world treatment patterns, healthcare resource utilisation and costs in patients with systemic lupus erythematosus treated with belimumab: a retrospective analysis of claims data in the USA
  1. Christopher F Bell1,
  2. Julie Priest2,
  3. Marni Stott-Miller3,
  4. Hong Kan4,5,
  5. Justyna Amelio6,
  6. Xue Song7,
  7. Brendan Limone7,
  8. Virginia Noxon7 and
  9. Karen H Costenbader8
  1. 1US Value, Evidence and Outcomes, GSK, Research Triangle Park, North Carolina, USA
  2. 2US Health Outcomes, ViiV Healthcare, Research Triangle Park, North Carolina, USA
  3. 3Epidemiology, Value Evidence and Outcomes, GSK, Uxbridge, UK
  4. 4Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  5. 5Global Patient Outcomes and Real World Evidence, Eli Lilly and Company, Indianapolis, Indiana, USA
  6. 6Epidemiology, Value Evidence and Outcomes, GSK, Stevenage, UK
  7. 7IBM Watson Health, Cambridge, Massachusetts, USA
  8. 8Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Christopher F Bell; christopher.f.bell{at}


Objective To examine the effects of belimumab initiation on healthcare resource utilisation (HCRU) and costs in SLE.

Methods This retrospective observational cohort study used healthcare administrative claims data from the IBM MarketScan Commercial Claims and Encounters Database to identify patients with SLE billing codes who received ≥1 intravenous belimumab infusion between March 2011 and December 2015. The first belimumab administration was the ‘index date’. During the 6-month postindex period, nine belimumab infusions were recommended: three during the initiation period and six during the maintenance period. HCRU and cost data for inpatient admissions, emergency department visits, physician office visits, hospital-based outpatient visits, laboratory services, other outpatient services and outpatient pharmacy prescriptions were compared in the 6-month pre/postindex periods.

Results Of the 1879 patients with SLE included, 43% received ≥3 intravenous initiation administrations. An average of 5.3 (SD: 2.4) of the nine recommended belimumab administrations were received within 6 months. In the 6-month preindex versus postindex periods, significant reductions were noted for inpatient hospitalisations (18% vs 9%, p<0.001; mean visits: 0.3 vs 0.14, p<0.001) and emergency department visits (40% vs 24%, p<0.001; mean visits; 3.53 vs 1.96, p<0.001). Mean total costs were higher in the 6-month postindex versus preindex period ($41 426 vs $29 270; p<0.001).

Conclusions In this study of real-world intravenous belimumab for SLE, adherence to recommended infusion schedules was low. Outpatient healthcare and associated costs were higher in the 6 months after belimumab was initiated, although inpatient costs were lower. Reasons for non-adherence with belimumab and implications should be investigated.

  • economic evaluations/burden of disease
  • treatment
  • systemic lupus erythematosus

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  • Contributors CFB, XS, BL and VN contributed to the conception or design of the study, acquisition of data, and data analysis or interpretation. JP, MSM, HK, JA and KHC contributed to the conception or design of the study and data analysis or interpretation. The study sponsor (GSK) contributed to collection, analysis and interpretation of the data, and the decision to submit the paper for publication, and supported the authors in development of the manuscript. All authors, including those employed by GSK, approved the content of the submitted manuscript.

  • Funding This study (206345) was funded by GSK.

  • Competing interests CFB, JP (at the time of study), MSM and JA are employees of GSK and hold stocks/shares in the company. KHC has received consulting fees and/or honoraria from AstraZeneca, Biogen Idec and GSK, and a research grant from Merck. XS, BL and VN are employees of IBM Watson Health, which received funding from GSK to conduct this research. HK holds shares in GSK.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval As the study used only deidentified patient data, it was exempt from Institutional Review Board review/approval.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. GSK is committed to publicly disclosing the results of GSK-sponsored clinical research that evaluates GSK medicines, and as such was involved in the decision to submit. Study documents can be requested for further research from Researchers can enquire about the availability of data from GSK clinical studies that are not listed on the site before they submit a research proposal.

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