Health care utilization and costs of systemic lupus erythematosus in the United States: A systematic review

Lin, Diana; Murimi-Worstell, Irene B.; Kan, Hong; Tierce, Jonothan C.; Wang, Xia; Nab, Henk; Desta, Barnabas; Hammond, Edward R.; Alexander, G. Caleb

doi:10.1177/09612033221088209

Cited by 9 publications

(4 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other items reported in this systematic review (like individual drug consumes) could not be compared with our results since we have not individualized each drug separately. 30 Many studies have evaluated costs in the caring of patients with SLE through quantification of HCRU. The relationship between severity of lupus and disease costs has been demonstrated in cohorts from different countries.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Burden of lupus activity on health care resources utilization in Buenos Aires, Argentina

Alvarado,

Alle,

Tobar–Jaramillo

et al. 2023

Lupus

View full text Add to dashboard Cite

Objective The aim is to analyze health care resource utilization (HCRU) of patients with lupus (SLE) from a health management organization (HMO) in Buenos Aires, Argentina, compared with matched controls and comparing periods of flare, low disease activity, and remission. Methods This is a retrospective observational study including all SLE incident cases (ACR 1997/SLICC 2012 criteria) between 2000 and 2020 and 5 matched controls. Clinical data and HCRU (medical and nonmedical consultations, lab and imaging tests performed, emergency room visits, hospitalizations, and drugs prescribed) were obtained from administrative databases and electronic medical records. For each patient with SLE, an activity state was determined in every month of follow-up: flare (BILAG A or 2 BILAG B); low disease activity (LLDAS); remission (DORIS definition); or intermediate activity (not fulfilling any of previous). Incidence rates for each HCRU item and incidence rate ratios between SLE and control patients were and between remission and flare periods were calculated. Multivariate negative binomial logistic regression analyses were performed for identification of variables associated with major resource use. Results A total of 62 SLE and 310 control patients were included, 88.7% were women, the median age at diagnosis was 46 years, and were followed for more than 8 years. Patients with SLE contributed with 537.2 patient-years (CI 95% 461.1–613.3) and controls with 2761.9 patient-years (CI 95% 2600.9–2922.8). HCRU in patients with SLE was significantly higher than in controls in all items, even in remission periods. Patients with SLE remained 74.4% of the time in remission, 12.1% in LLDAS, 12.2% in intermediate activity, and 1.3% in flare (there were 64 flares in 36 patients). HCRU was significantly higher during flare periods compared with remission periods. Number of flares was independently associated with emergency department consultations, lab tests and X-ray performed, number of drugs prescribed, and hospitalizations. Conclusion Significantly more HCRU was observed in patients with SLE in flare compared to remission periods.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Other items reported in this systematic review (like individual drug consumes) could not be compared with our results since we have not individualized each drug separately. 30…”

Section: Discussionmentioning

confidence: 99%

Burden of lupus activity on health care resources utilization in Buenos Aires, Argentina

Alvarado,

Alle,

Tobar–Jaramillo

et al. 2023

Lupus

View full text Add to dashboard Cite

show abstract

“…SLE is associated with a high economic burden on the healthcare system, with mean annual all-cause healthcare costs per patient in the USA between US$17,258 and US$63,022 [11][12][13][14]. Although data are somewhat limited, several studies have shown that patients with LN incurred between two and four times the healthcare resource utilization (HCRU) and costs compared with patients with SLE without LN and between two and six times the costs of matched controls without SLE [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Healthcare Resource Utilization and Associated Costs in Patients With Systemic Lupus Erythematosus Diagnosed With Lupus Nephritis

Bell¹,

Wu²,

Huang³

et al. 2023

Cureus

View full text Add to dashboard Cite

Background: Lupus nephritis (LN) is among the most severe organ manifestations of systemic lupus erythematosus (SLE), affecting between 31% and 48% of patients, usually within five years of SLE diagnosis. SLE without LN is associated with a high economic burden on the healthcare system, and although data are limited, several studies have shown that SLE with LN could increase this burden.Aim: We aimed to compare the economic burden of LN versus SLE without LN among patients managed in routine clinical practices in the USA and describe the clinical course of these patients.Materials and methods: This was a retrospective observational study of patients with commercial or Medicare Advantage health insurance. It included 2310 patients with LN and 2310 matched patients who had SLE without LN; each patient was followed for 12 months after diagnosis (the patient's index date). Outcome measures included healthcare resource utilization (HCRU), direct healthcare costs, and SLE clinical manifestations.Results: In all healthcare settings, the mean (SD) use of all-cause healthcare resources was significantly higher in the LN versus SLE without LN cohort, including the mean number of ambulatory visits (53.9 (55.1) vs 33.0 (26.0)), emergency room visits (2.9 (7.9) vs 1.6 (3.3)), inpatient stays (0.9 (1.5) vs 0.3 (0.8)), and pharmacy fills (65.0 (48.3) vs 51.2 (42.6)) (all p<0.001). Total all-cause costs per patient in the LN cohort were also significantly higher compared with the SLE without LN cohort ($50,975 (86,281) vs $26,262 (52,720), p<0.001), including costs for inpatient stays and outpatient visits. Clinically, a significantly higher proportion of patients with LN experienced moderate or severe SLE flares compared with the SLE without LN cohort (p<0.001), which may explain the difference in HCRU and healthcare costs.Conclusion: All-cause HCRU and costs were higher for patients with LN than for matched patients with SLE without LN, highlighting the economic burden associated with LN.

show abstract

“…The prevalence of autoimmune disease is estimated to be between 3-5% worldwide ( 7 ), and it is a well-established fact that rates of diagnosis are on the rise. The reported mean annual direct costs per patient with systemic lupus erythematosus (SLE) are somewhere between $17,258 and $63,022 regardless of the presence of nephritis ( 8 ). Considering all patients with SLE, this equates to $1.4 to $3.2 billion per year ( 9 ), and this is but one of over a 100 distinct disease entities.…”

Section: Introductionmentioning

confidence: 99%

Foxp3+ regulatory T cell therapy for tolerance in autoimmunity and solid organ transplantation

et al. 2022

View full text Add to dashboard Cite

Regulatory T cells (Tregs) are critical for tolerance in humans. The exact mechanisms by which the loss of peripheral tolerance leads to the development of autoimmunity and the specific role Tregs play in allograft tolerance are not fully understood; however, this population of T cells presents a unique opportunity in the development of targeted therapeutics. In this review, we discuss the potential roles of Foxp3+ Tregs in the development of tolerance in transplantation and autoimmunity, and the available data regarding their use as a treatment modality.

show abstract

Health care utilization and costs of systemic lupus erythematosus in the United States: A systematic review

Cited by 9 publications

References 67 publications

Burden of lupus activity on health care resources utilization in Buenos Aires, Argentina

Burden of lupus activity on health care resources utilization in Buenos Aires, Argentina

Healthcare Resource Utilization and Associated Costs in Patients With Systemic Lupus Erythematosus Diagnosed With Lupus Nephritis

Foxp3+ regulatory T cell therapy for tolerance in autoimmunity and solid organ transplantation

Contact Info

Product

Resources

About