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

Author:

Lin Dora H1,Murimi-Worstell Irene B1,Kan Hong2,Tierce Jonothan C1,Wang Xia3,Nab Henk4,Desta Barnabas5,Hammond Edward R6,Alexander G Caleb7

Affiliation:

1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

2. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

3. Data Science & Artificial Intelligence, BioPharmaceuticals R&D, AstraZeneca, Gaithersburg, MD, USA

4. Inflammation & Autoimmunity, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK

5. Global Pricing and Market Access, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA

6. Epidemiology, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA

7. Center for Drug Safety and Effectiveness, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

Abstract

Objectives To evaluate health care utilization and costs for patients with systemic lupus erythematosus (SLE) by disease severity. Methods We searched PubMed and Embase from January 2000 to June 2020 for observational studies examining health care utilization and costs associated with SLE among adults in the United States. Two independent reviewers reviewed the selected full-text articles to determine the final set of included studies. Costs were converted to 2020 US $. Results We screened 9224 articles, of which 51 were included. Mean emergency department visits were 0.3–3.5 per year, and mean hospitalizations were 0.1–2.4 per year (mean length of stay 0.4–13.0 days). Patients averaged 10–26 physician visits/year. Mean annual direct total costs were $17,258–$63,022 per patient and were greater for patients with moderate or severe disease ($19,099–$82,391) compared with mild disease ($12,242–$29,233). Mean annual direct costs were larger from commercial claims ($24,585–$63,022) than public payers (Medicare and Medicaid: $18,302–$27,142). Conclusions SLE remains a significant driver of health care utilization and costs. Patients with moderate to severe SLE use more health care services and incur greater direct and indirect costs than those with mild disease.

Funder

AstraZeneca

Publisher

SAGE Publications

Subject

Rheumatology

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