STATinMED Research, Ann Arbor, MI, USA.
Janssen Research & Development, LLC, Horsham, PA, USA.
J Med Econ. 2020 Jan;23(1):1-9. doi: 10.1080/13696998.2019.1678170. Epub 2019 Oct 21.
Systemic lupus erythematosus (SLE) is a multifaceted autoimmune disease involving multiple organs systems and places a significant economic burden on SLE patients. There is a literature gap regarding the standard of care and economic burden in SLE patients, their families, and society. This study assessed medication use patterns among SLE patients and generated the annual and total economic burden associated with the illness. Adult patients with ≥2 medical claims on different dates for SLE diagnoses were identified from 01 January 2013 to 31 December 2015 using two large administrative claims databases representative of the commercially insured US population. Patient demographics and clinical characteristics during 1-year pre-SLE diagnosis were assessed. Outcomes including the proportion of patients who used SLE medications and annual costs were assessed 1-year post-SLE diagnosis. Total costs related to SLE were extrapolated to the US population to estimate the economic burden based on SLE prevalence. A total of 30,086 SLE patients were identified. The most common baseline comorbidities were hypertension and infections. Corticosteroids and hydroxychloroquine were the most common SLE medications. Biologics utilization was minimal. SLE patients had, on average, 26.0 physician visits, 23.7 prescription claims, 1.7 inpatient admissions, and 2.0 hospital days per patient 1-year post-SLE diagnosis. Annual all-cause median costs among all SLE patients were $8712 per patient per year. Total costs ranged between $1.4-1.6 and $2.8-3.2 billion per year, depending on prevalence estimates. Our findings indicate a nominal use of biologics (∼2%) among SLE patients; despite belimumab being one of the few approved treatments for SLE in the USA. These data reveal an unmet need for availability of advanced SLE therapy, and future studies are warranted concerning the underlying causes. SLE is also associated with a substantial economic burden of ≤3.2 billion per year. These findings may assist in future planning and resource allocation.
系统性红斑狼疮（SLE）是一种多方面的自身免疫性疾病，涉及多个器官系统，并给 SLE 患者带来了巨大的经济负担。关于 SLE 患者、他们的家庭和社会的标准治疗和经济负担存在文献空白。本研究评估了 SLE 患者的药物使用模式，并计算了与疾病相关的年度和总经济负担。从 2013 年 1 月 1 日至 2015 年 12 月 31 日，使用两个具有代表性的大型行政索赔数据库，从两个大型行政索赔数据库中确定了≥2 份不同日期用于 SLE 诊断的医疗索赔的成年患者。评估了 1 年前 SLE 诊断前患者的人口统计学和临床特征。评估了 SLE 诊断后 1 年患者使用 SLE 药物的比例和年度费用。根据 SLE 患病率，将与 SLE 相关的总费用外推至美国人群，以估计经济负担。共确定了 30086 例 SLE 患者。最常见的基线合并症是高血压和感染。皮质类固醇和羟氯喹是最常见的 SLE 药物。生物制剂的利用率很低。SLE 患者在 SLE 诊断后 1 年内平均有 26.0 次就诊、23.7 次处方、1.7 次住院和 2.0 天住院。所有 SLE 患者的年度全因中位数费用为每位患者每年 8712 美元。根据流行率估计，每年的总成本范围在 14-16 亿美元至 28-32 亿美元之间。我们的研究结果表明，SLE 患者生物制剂的使用量很少（约 2%）；尽管贝鲁单抗是美国批准用于治疗 SLE 的少数几种药物之一。这些数据表明 SLE 治疗的高级药物存在未满足的需求，需要进一步研究潜在原因。SLE 每年还带来≤32 亿美元的巨大经济负担。这些发现可能有助于未来的规划和资源分配。
