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Abstract
Objective To assess the economic burden of patients with SLE by disease severity in the USA 1 year before and after diagnosis.
Methods Patients aged ≥18 years with a first SLE diagnosis (index date) between January 2005 and December 2014 were identified from administrative commercial claims data linked to electronic medical records (EMRs). Disease severity during the year after diagnosis was classified as mild, moderate, or severe using claims-based algorithms and EMR data. Healthcare resource utilisation (HCRU) and all-cause healthcare costs (2017 US$) were reported for 1 year pre-diagnosis and post-diagnosis. Generalised linear modelling examined all-cause costs over 1 year post-index, adjusting for baseline demographics, clinical characteristics, Charlson Comorbidity Index and 1 year pre-diagnosis costs.
Results Among 2227 patients, 26.3% had mild, 51.0% moderate and 22.7% severe SLE. Mean per-patient costs were higher for patients with moderate and severe SLE compared with mild SLE during the year before diagnosis: mild US$12 373, moderate $22 559 and severe US$39 261 (p<0.0001); and 1-year post-diagnosis period: mild US$13 415, moderate US$29 512 and severe US$68 260 (p<0.0001). Leading mean cost drivers were outpatient visits (US$13 566) and hospitalisations (US$10 252). Post-diagnosis inpatient utilisation (≥1 stay) was higher for patients with severe (51.2%) and moderate (22.4%) SLE, compared with mild SLE (12.8%), with longer mean hospital stays: mild 0.47 days, moderate 1.31 days and severe 5.52 days (p<0.0001).
Conclusion HCRU and costs increase with disease severity in the year before and after diagnosis; leading cost drivers post-diagnosis were outpatient visits and hospitalisations. Earlier diagnosis and treatment may improve health outcomes and reduce HCRU and costs.
- lupus erythematosus
- systemic
- cost of illness
- autoimmune diseases
Data availability statement
Data are available upon reasonable request. Data underlying the findings described in this manuscript may be obtained in accordance with AstraZeneca’s data sharing policy described at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. This study is based on de-identified data obtained and analysed by IQVIA under license from IBM MarketScan and GE Healthcare, and so are not publicly available. The interpretation and conclusions contained in this study are those of the authors alone. The authors do not own these data and hence are not permitted to share the data in the original form.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Data availability statement
Data are available upon reasonable request. Data underlying the findings described in this manuscript may be obtained in accordance with AstraZeneca’s data sharing policy described at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. This study is based on de-identified data obtained and analysed by IQVIA under license from IBM MarketScan and GE Healthcare, and so are not publicly available. The interpretation and conclusions contained in this study are those of the authors alone. The authors do not own these data and hence are not permitted to share the data in the original form.
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Footnotes
Presented at Data were presented at the American College of Rheumatology/Association of Rheumatology Professionals (ACR/ARP) 2019 Annual Meeting, Atlanta, GA, 8–13 November 2019.
Contributors ERH, BD, XW and MJ conceived and designed the study. AMN acquired the data and designed the study. All authors analysed and interpreted the data. All authors were involved in development, review and final approval of the manuscript.
Funding Analysis supported by AstraZeneca.
Competing interests MJ, BD, XW and ERH are employees of AstraZeneca. AMN is an employee of IQVIA and was paid by AstraZeneca to conduct this research study.
Provenance and peer review Not commissioned; externally peer reviewed.
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