Healthcare Resource Use and Costs Associated with Organ Damage in Newly Diagnosed Adults with Systemic Lupus Erythematosus in the UK
Abstract Introduction This analysis compared healthcare resource use (HCRU) and costs associated with incident organ damage in a cohort of adult patients with systemic lupus erythematosus (SLE). Methods Incident SLE cases were identified (Clinical Practice Research Datalink [CPRD] and Hospital Episo...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2023-07-01
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| Series: | Rheumatology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40744-023-00567-9 |
| _version_ | 1797699184245080064 |
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| author | Heide A. Stirnadel-Farrant Sarowar M. Golam Barbara Naisbett-Groet Danny Gibson Julia Langham Sue Langham Mihail Samnaliev |
| author_facet | Heide A. Stirnadel-Farrant Sarowar M. Golam Barbara Naisbett-Groet Danny Gibson Julia Langham Sue Langham Mihail Samnaliev |
| author_sort | Heide A. Stirnadel-Farrant |
| collection | DOAJ |
| description | Abstract Introduction This analysis compared healthcare resource use (HCRU) and costs associated with incident organ damage in a cohort of adult patients with systemic lupus erythematosus (SLE). Methods Incident SLE cases were identified (Clinical Practice Research Datalink [CPRD] and Hospital Episode Statistics-linked healthcare databases; January 1, 2005–June 30, 2019). Annual incidence of 13 organ damage domains was calculated from SLE diagnosis through follow-up. Annualized HCRU and costs were compared between organ damage and non-organ damage patient groups using generalized estimating equations. Results A total of 936 patients met the inclusion criteria for SLE. Mean age was 48.0 (standard deviation [SD] 15.7) years and 88% were female. Over a median follow-up period of 4.3 (interquartile range [IQR] 1.9–7.0) years, 59% (315/533) had evidence of post-SLE diagnosis incident organ damage (≥ 1 type), which was greatest for musculoskeletal (146/819 [18%]), cardiovascular (149/842 [18%]), and skin (148/856 [17%]) domains. Patients with organ damage had greater resource use for all organ systems, excluding gonadal, versus those without it. Overall, mean (SD) annualized all-cause HCRU was greater in patients with organ damage versus those without it (inpatient, 1.0 versus 0.2; outpatient, 7.3 versus 3.5; accident and emergency, 0.5 versus 0.2 days; primary care contacts, 28.7 versus 16.5; prescription medications, 62.3 versus 22.9). Adjusted mean annualized all-cause costs were significantly greater in both post- and pre-organ damage index periods for patients with organ damage versus those without it (all P < 0.05, excluding gonadal). Overall organ damage was associated with significantly increased adjusted mean annualized per-patient cost (£4442 greater [P < 0.0001]) ranging between £2709 and £7150 greater depending on the organ damage type. Conclusion Organ damage was associated with higher HCRU and healthcare costs, before and after SLE diagnosis. More effective SLE management may slow disease progression, prevent organ damage onset, improve clinical outcomes, and reduce healthcare costs. |
| first_indexed | 2024-03-12T04:04:19Z |
| format | Article |
| id | doaj.art-225ac143668d4ac5a190ba3d0c663488 |
| institution | Directory Open Access Journal |
| issn | 2198-6576 2198-6584 |
| language | English |
| last_indexed | 2024-03-12T04:04:19Z |
| publishDate | 2023-07-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Rheumatology and Therapy |
| spelling | doaj.art-225ac143668d4ac5a190ba3d0c6634882023-09-03T11:24:36ZengAdis, Springer HealthcareRheumatology and Therapy2198-65762198-65842023-07-011051183119710.1007/s40744-023-00567-9Healthcare Resource Use and Costs Associated with Organ Damage in Newly Diagnosed Adults with Systemic Lupus Erythematosus in the UKHeide A. Stirnadel-Farrant0Sarowar M. Golam1Barbara Naisbett-Groet2Danny Gibson3Julia Langham4Sue Langham5Mihail Samnaliev6BioPharmaceuticals Medical, AstraZenecaBioPharmaceuticals Medical, AstraZenecaBioPharmaceuticals Medical, AstraZenecaHealth Economics, AstraZenecaEpidemiology Group, Maverex LimitedHealth Economics Group, Maverex LimitedStatistical Group, Maverex LimitedAbstract Introduction This analysis compared healthcare resource use (HCRU) and costs associated with incident organ damage in a cohort of adult patients with systemic lupus erythematosus (SLE). Methods Incident SLE cases were identified (Clinical Practice Research Datalink [CPRD] and Hospital Episode Statistics-linked healthcare databases; January 1, 2005–June 30, 2019). Annual incidence of 13 organ damage domains was calculated from SLE diagnosis through follow-up. Annualized HCRU and costs were compared between organ damage and non-organ damage patient groups using generalized estimating equations. Results A total of 936 patients met the inclusion criteria for SLE. Mean age was 48.0 (standard deviation [SD] 15.7) years and 88% were female. Over a median follow-up period of 4.3 (interquartile range [IQR] 1.9–7.0) years, 59% (315/533) had evidence of post-SLE diagnosis incident organ damage (≥ 1 type), which was greatest for musculoskeletal (146/819 [18%]), cardiovascular (149/842 [18%]), and skin (148/856 [17%]) domains. Patients with organ damage had greater resource use for all organ systems, excluding gonadal, versus those without it. Overall, mean (SD) annualized all-cause HCRU was greater in patients with organ damage versus those without it (inpatient, 1.0 versus 0.2; outpatient, 7.3 versus 3.5; accident and emergency, 0.5 versus 0.2 days; primary care contacts, 28.7 versus 16.5; prescription medications, 62.3 versus 22.9). Adjusted mean annualized all-cause costs were significantly greater in both post- and pre-organ damage index periods for patients with organ damage versus those without it (all P < 0.05, excluding gonadal). Overall organ damage was associated with significantly increased adjusted mean annualized per-patient cost (£4442 greater [P < 0.0001]) ranging between £2709 and £7150 greater depending on the organ damage type. Conclusion Organ damage was associated with higher HCRU and healthcare costs, before and after SLE diagnosis. More effective SLE management may slow disease progression, prevent organ damage onset, improve clinical outcomes, and reduce healthcare costs.https://doi.org/10.1007/s40744-023-00567-9CostsHealthcare resource useOrgan damageSystemic lupus erythematosus |
| spellingShingle | Heide A. Stirnadel-Farrant Sarowar M. Golam Barbara Naisbett-Groet Danny Gibson Julia Langham Sue Langham Mihail Samnaliev Healthcare Resource Use and Costs Associated with Organ Damage in Newly Diagnosed Adults with Systemic Lupus Erythematosus in the UK Rheumatology and Therapy Costs Healthcare resource use Organ damage Systemic lupus erythematosus |
| title | Healthcare Resource Use and Costs Associated with Organ Damage in Newly Diagnosed Adults with Systemic Lupus Erythematosus in the UK |
| title_full | Healthcare Resource Use and Costs Associated with Organ Damage in Newly Diagnosed Adults with Systemic Lupus Erythematosus in the UK |
| title_fullStr | Healthcare Resource Use and Costs Associated with Organ Damage in Newly Diagnosed Adults with Systemic Lupus Erythematosus in the UK |
| title_full_unstemmed | Healthcare Resource Use and Costs Associated with Organ Damage in Newly Diagnosed Adults with Systemic Lupus Erythematosus in the UK |
| title_short | Healthcare Resource Use and Costs Associated with Organ Damage in Newly Diagnosed Adults with Systemic Lupus Erythematosus in the UK |
| title_sort | healthcare resource use and costs associated with organ damage in newly diagnosed adults with systemic lupus erythematosus in the uk |
| topic | Costs Healthcare resource use Organ damage Systemic lupus erythematosus |
| url | https://doi.org/10.1007/s40744-023-00567-9 |
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