The cost of care of systemic lupus erythematosus (SLE) in the UK: annual direct costs for adult SLE patients with active autoantibody-positive disease

Author:

Khamashta MA1,Bruce IN23,Gordon C45,Isenberg DA6,Ateka-Barrutia O1,Gayed M45,Donatti C7,Guillermin A-L7,Foo J8,Perna A9

Affiliation:

1. Lupus Research Unit, The Rayne Institute, St Thomas’ Hospital, London, UK

2. Arthritis Research UK Epidemiology Unit, Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK

3. NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK

4. Rheumatology Department, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK

5. University of Birmingham, Birmingham, UK

6. Centre for Rheumatology, Division of Medicine, University College London, London, UK

7. Health Economics and Outcomes Research Unit, IMS Health, London, UK

8. Health Outcomes, GlaxoSmithKline, London, UK

9. Global Immuno-Inflammation and Infectious Diseases Franchise, GlaxoSmithKline, London, UK

Abstract

Objectives The aim of the Systemic LUpus Erythematosus Cost of Care In Europe (LUCIE) study was to evaluate the annual direct medical costs of managing adults with active autoantibody-positive disease on medication for SLE in secondary care. This paper presents the UK analyses only. Methods A cost-of-illness study was conducted from the perspective of the National Health Service. Health resource utilization data were retrieved over a two-year period from four centres in England and unit cost data were taken from published sources. Results At baseline, 86 patients were included, 38 (44.2%) had severe SLE and 48 (55.8%) had non-severe SLE. The mean (SD) SELENA-SLEDAI score was 7.7 (5.7). The mean (SD) annual direct medical cost of was estimated at £3231 (£2333) per patient and was 2.2 times higher in patients with severe SLE compared with patients with non-severe SLE ( p < 0.001). Multivariate model analyses showed that renal disease involvement ( p = 0.0016) and severe flares ( p = 0.0001) were associated with higher annual direct costs. Conclusions Improvement of the overall stability of SLE and early intervention to minimize the impact of renal disease may be two approaches to mitigate the long-term direct cost of managing SLE patients in the UK.

Publisher

SAGE Publications

Subject

Rheumatology

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