Schwarting Andreas, Friedel Heiko, Garal-Pantaler Elena, Pignot Marc, Wang Xia, Nab Henk, Desta Barnabas, Hammond Edward R
Rheumatology and Clinical Immunology, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
Versorgungsforschung und Gesundheitsökonomie, Team Gesundheit GmbH, Rellinghauser Straße 93, 45128, Essen, Germany.
Rheumatol Ther. 2021 Mar;8(1):375-393. doi: 10.1007/s40744-021-00277-0. Epub 2021 Feb 5.
We evaluated incidence, prevalence, costs, and healthcare utilization associated with systemic lupus erythematosus (SLE) in patients in Germany.
Adult patients with SLE were identified from the German Betriebskrankenkassen (BKK) health insurance fund database between 2009 and 2014. SLE incidence and prevalence were calculated for each year and extrapolated (age and sex adjusted) to the German population. The 2009 SLE population was followed through 2014. Healthcare utilization and costs for patients with SLE were calculated and compared with controls matched by age, sex, and baseline Charlson Comorbidity Index scores.
This analysis included 1160 patients with SLE. Estimated SLE incidence between 2009 and 2014 ranged from 4.59 to 6.89 per 100,000 persons and prevalence ranged from 37.32 to 47.36 per 100,000. SLE incidence in Germany in 2014 was 8.82 per 100,000 persons; prevalence was 55.80 (corrected for right-censored data). At baseline, 12.8, 41.7, and 45.5% of patients were categorized as having mild, moderate, and severe SLE, respectively. Patients with SLE had greater mean (standard deviation [SD]) annual medical costs compared with matched controls 1 year after index diagnosis (€6895 [14,424] vs. €3692 [3994]; P < 0.0001) and in subsequent years. Patients with moderate or severe SLE had significantly more hospitalizations, outpatient visits, and prescription medication use compared with matched controls. Mean annual costs for 5 years ranged from €1890 to 3010, €4867 to 5876, and €8396 to 10,001 for patients with mild, moderate, and severe SLE, respectively.
SLE incidence in Germany increased 1.4-fold over 5 years. Patients with SLE have higher healthcare costs, and costs increase with baseline severity. Early and effective treatments may delay progression and reduce the burden of SLE.
我们评估了德国系统性红斑狼疮（SLE）患者的发病率、患病率、成本及医疗保健利用情况。
从德国企业健康保险基金（BKK）数据库中识别出2009年至2014年期间的成年SLE患者。计算每年的SLE发病率和患病率，并（按年龄和性别调整后）推算至德国人口。对2009年的SLE患者群体随访至2014年。计算SLE患者的医疗保健利用情况和成本，并与按年龄、性别和基线查尔森合并症指数评分匹配的对照组进行比较。
该分析纳入了1160例SLE患者。2009年至2014年期间估计的SLE发病率为每10万人4.59至6.89例，患病率为每10万人37.32至47.36例。2014年德国的SLE发病率为每10万人8.82例；患病率为55.80（经右删失数据校正）。基线时，分别有12.8%、41.7%和45.5%的患者被分类为轻度、中度和重度SLE。与匹配的对照组相比，SLE患者在索引诊断后1年（6895欧元[14424]对3692欧元[3994]；P＜0.0001）及随后几年的平均（标准差[SD]）年度医疗成本更高。与匹配的对照组相比，中度或重度SLE患者的住院、门诊就诊和处方药使用显著更多。轻度、中度和重度SLE患者5年的平均年度成本分别为1890至3010欧元、4867至5876欧元和8396至10001欧元。
德国的SLE发病率在5年内增加了1.4倍。SLE患者的医疗成本更高，且成本随基线严重程度增加。早期有效治疗可能会延缓疾病进展并减轻SLE负担。
