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Annual direct medical cost of active systemic lupus erythematosus in five European countries

Doria, Andrea; Amoura, Zahir; Cervera, Ricard; Khamastha, Munther A.; Schneider, Matthias; Richter, Jutta; Guillemin, Francis; Kobelt, Gisela LU ; Maurel, Frederique and Garofano, Anna, et al. (2014) In Annals of the Rheumatic Diseases 73(1). p.154-160
Abstract
Objectives To evaluate the annual direct medical cost of managing adult systemic lupus erythematosus (SLE) patients with active autoantibody positive disease in Europe. Methods A 2-year, retrospective, multicentre, observational study was conducted in five countries (France, Germany, Italy, Spain and the UK). Data included patients' characteristics, disease activity and severity, flare assessments and health resource use (eg, laboratory tests, medications, specialist visits and hospitalisations). Costs were assessed from the public payers' perspective. Cost predictors were estimated by multivariate regression models. Results Thirty-one centres enrolled 427 consecutive eligible patients stratified equally by disease severity. At baseline,... (More)
Objectives To evaluate the annual direct medical cost of managing adult systemic lupus erythematosus (SLE) patients with active autoantibody positive disease in Europe. Methods A 2-year, retrospective, multicentre, observational study was conducted in five countries (France, Germany, Italy, Spain and the UK). Data included patients' characteristics, disease activity and severity, flare assessments and health resource use (eg, laboratory tests, medications, specialist visits and hospitalisations). Costs were assessed from the public payers' perspective. Cost predictors were estimated by multivariate regression models. Results Thirty-one centres enrolled 427 consecutive eligible patients stratified equally by disease severity. At baseline, mean (SD) age was 44.5 (13.8) years, 90.5% were women and mean (SD) SLE duration was 10.7 (8.0) years. The SELENA-SLEDAI (11.2 vs 5.3) and SLICC/ACR index (1.0 vs 0.7) scores were higher in severe patients. Over the study period, patients experienced on average 1.02 (0.71) flares/year. The mean annual direct medical cost was higher in severe compared to non-severe patients (Euro4748 vs Euro2650, p<0.001). Medication costs were Euro2518 in severe versus Euro1251 in non-severe patients (p<0.001). Medications represented 53% and 47% of the total cost for severe and non-severe patients, respectively, primarily due to immunosuppressants and biologics. Flares, especially severe flares, were identified as the major cost predictor, with each flare increasing the annual total cost by about Euro1002 (p<0.001). Conclusions The annual direct medical cost of SLE patients in Europe is related to disease severity and flares. Medical treatments were the main cost drivers. Severe flares and major organ involvement were identified as important cost predictors. (Less)
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published
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keywords
Systemic Lupus Erythematosus, Disease Activity, Autoantibodies, Economic, Evaluations, Autoimmune Diseases
in
Annals of the Rheumatic Diseases
volume
73
issue
1
pages
154 - 160
publisher
British Medical Association
external identifiers
  • wos:000327835100028
  • scopus:84889686860
ISSN
1468-2060
DOI
10.1136/annrheumdis-2012-202443
language
English
LU publication?
yes
id
9b621807-7cb1-4430-8d5d-5c8ac9cb2fbc (old id 4272279)
date added to LUP
2014-02-10 12:18:39
date last changed
2017-10-29 03:46:42
@article{9b621807-7cb1-4430-8d5d-5c8ac9cb2fbc,
  abstract     = {Objectives To evaluate the annual direct medical cost of managing adult systemic lupus erythematosus (SLE) patients with active autoantibody positive disease in Europe. Methods A 2-year, retrospective, multicentre, observational study was conducted in five countries (France, Germany, Italy, Spain and the UK). Data included patients' characteristics, disease activity and severity, flare assessments and health resource use (eg, laboratory tests, medications, specialist visits and hospitalisations). Costs were assessed from the public payers' perspective. Cost predictors were estimated by multivariate regression models. Results Thirty-one centres enrolled 427 consecutive eligible patients stratified equally by disease severity. At baseline, mean (SD) age was 44.5 (13.8) years, 90.5% were women and mean (SD) SLE duration was 10.7 (8.0) years. The SELENA-SLEDAI (11.2 vs 5.3) and SLICC/ACR index (1.0 vs 0.7) scores were higher in severe patients. Over the study period, patients experienced on average 1.02 (0.71) flares/year. The mean annual direct medical cost was higher in severe compared to non-severe patients (Euro4748 vs Euro2650, p&lt;0.001). Medication costs were Euro2518 in severe versus Euro1251 in non-severe patients (p&lt;0.001). Medications represented 53% and 47% of the total cost for severe and non-severe patients, respectively, primarily due to immunosuppressants and biologics. Flares, especially severe flares, were identified as the major cost predictor, with each flare increasing the annual total cost by about Euro1002 (p&lt;0.001). Conclusions The annual direct medical cost of SLE patients in Europe is related to disease severity and flares. Medical treatments were the main cost drivers. Severe flares and major organ involvement were identified as important cost predictors.},
  author       = {Doria, Andrea and Amoura, Zahir and Cervera, Ricard and Khamastha, Munther A. and Schneider, Matthias and Richter, Jutta and Guillemin, Francis and Kobelt, Gisela and Maurel, Frederique and Garofano, Anna and Perna, Alessandra and Murray, Miranda and Schmitt, Claude and Boucot, Isabelle},
  issn         = {1468-2060},
  keyword      = {Systemic Lupus Erythematosus,Disease Activity,Autoantibodies,Economic,Evaluations,Autoimmune Diseases},
  language     = {eng},
  number       = {1},
  pages        = {154--160},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {Annual direct medical cost of active systemic lupus erythematosus in five European countries},
  url          = {http://dx.doi.org/10.1136/annrheumdis-2012-202443},
  volume       = {73},
  year         = {2014},
}