Hermine I Brunner1, Tina M Sherrard, Marisa S Klein-Gitelman. 1. Cincinnati Children's Hospital Medical Center, William Rowe Division of Rheumatology E 4010, University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA. hermine.brunner@cchmc.org
Abstract
OBJECTIVE: To determine the direct cost of care of children with childhood-onset systemic lupus erythematosus (cSLE), and to determine the direct cost per quality-adjusted life year (QALY) with cSLE. METHODS: Administrative databases from 2 large tertiary pediatric rheumatology centers in the United States were reviewed for all patients with cSLE (n = 119) diagnosed and regularly treated in these centers between January 2001 and April 2004. Health-related quality of life estimates for patients with cSLE (n = 297) reported in the literature were used to calculate QALYs based on global health ratings of the Child Health Questionnaire (range 0-100). RESULTS: Information on 3,184 patient-months of followup was included in the analysis. During a mean +/- SD followup of 27 +/- 11.8 months, the direct cost of care for the cohort amounted to $3,965,048, excluding outpatient medications. Irrespective of patient sex, the mean +/- SD cost of cSLE per month was $1,245 +/- $2,352, or approximately $14,944 per year. Inpatient and day hospital care accounted for 28% of the cost, laboratory testing accounted for 21%, inpatient/day-patient medication costs accounted for 13%, and dialysis accounted for 11%. Visits to the rheumatology clinic only contributed 9% to the direct cost of care. When including an estimated outpatient medication cost of $1,190, the direct cost of cSLE per QALY was $30,908. CONCLUSION: Children diagnosed with cSLE were found to have a considerable direct cost of care. The treatment of cSLE appears to be far more costly than that of adult SLE and juvenile idiopathic arthritis reported in the literature.
OBJECTIVE: To determine the direct cost of care of children with childhood-onset systemic lupus erythematosus (cSLE), and to determine the direct cost per quality-adjusted life year (QALY) with cSLE. METHODS: Administrative databases from 2 large tertiary pediatric rheumatology centers in the United States were reviewed for all patients with cSLE (n = 119) diagnosed and regularly treated in these centers between January 2001 and April 2004. Health-related quality of life estimates for patients with cSLE (n = 297) reported in the literature were used to calculate QALYs based on global health ratings of the Child Health Questionnaire (range 0-100). RESULTS: Information on 3,184 patient-months of followup was included in the analysis. During a mean +/- SD followup of 27 +/- 11.8 months, the direct cost of care for the cohort amounted to $3,965,048, excluding outpatient medications. Irrespective of patient sex, the mean +/- SD cost of cSLE per month was $1,245 +/- $2,352, or approximately $14,944 per year. Inpatient and day hospital care accounted for 28% of the cost, laboratory testing accounted for 21%, inpatient/day-patient medication costs accounted for 13%, and dialysis accounted for 11%. Visits to the rheumatology clinic only contributed 9% to the direct cost of care. When including an estimated outpatient medication cost of $1,190, the direct cost of cSLE per QALY was $30,908. CONCLUSION:Children diagnosed with cSLE were found to have a considerable direct cost of care. The treatment of cSLE appears to be far more costly than that of adult SLE and juvenile idiopathic arthritis reported in the literature.
Authors: Marie Tanzer; Cheryl Tran; Kassandra L Messer; Amber Kroeker; Emily Herreshoff; Larysa Wickman; Courtney Harkness; Peter Song; Debbie S Gipson Journal: Arthritis Care Res (Hoboken) Date: 2013-03 Impact factor: 4.794
Authors: Ornella J Rullo; Jennifer M P Woo; Miriam F Parsa; Alice D C Hoftman; Paul Maranian; David A Elashoff; Timothy B Niewold; Jennifer M Grossman; Bevra H Hahn; Maureen McMahon; Deborah K McCurdy; Betty P Tsao Journal: Arthritis Res Ther Date: 2013-01-23 Impact factor: 5.156