Megan R W Barber1, John G Hanly2, Li Su3, Murray B Urowitz4, Yvan St Pierre5, Juanita Romero-Diaz6, Caroline Gordon7, Sang-Cheol Bae8, Sasha Bernatsky9, Daniel J Wallace10, Joan T Merrill11, David A Isenberg12, Anisur Rahman12, Ellen M Ginzler13, Michelle Petri14, Ian N Bruce15, Mary A Dooley16, Paul R Fortin17, Dafna D Gladman4, Jorge Sanchez-Guerrero4, Kristjan Steinsson18, Rosalind Ramsey-Goldman19, Munther A Khamashta20, Cynthia Aranow21, Meggan Mackay21, Graciela S Alarcón22, Susan Manzi23, Ola Nived24, Andreas Jönsen24, Asad A Zoma25, Ronald F van Vollenhoven26, Manuel Ramos-Casals27, Guillermo Ruiz-Irastorza28, S Sam Lim29, Kenneth C Kalunian30, Murat Inanc31, Diane L Kamen32, Christine A Peschken33, Søren Jacobsen34, Anca Askanase35, Vernon Farewell3, Thomas Stoll36, Jill Buyon37, Ann E Clarke1. 1. University of Calgary, Alberta, Canada. 2. Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada. 3. University of Cambridge, Cambridge, UK. 4. Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada. 5. Research Institute of the McGill University Health Center, Montreal, Quebec, Canada. 6. Instituto Nacional de Ciencias Médicas y Nutricion, Mexico City, Mexico. 7. University of Birmingham, Birmingham, UK. 8. Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea. 9. McGill University Health Centre, Montreal, Quebec, Canada. 10. Cedars-Sinai Medical Center and University of California, Los Angeles. 11. Oklahoma Medical Research Foundation, Oklahoma City. 12. University College London, London, UK. 13. State University of New York Downstate Medical Center, Brooklyn. 14. Johns Hopkins University School of Medicine, Baltimore, Maryland. 15. Manchester Academic Health Sciences Centre, University of Manchester and Central Manchester University Hospitals National Health Service Foundation Trust, Manchester, UK. 16. University of North Carolina, Chapel Hill. 17. CHU de Québec, Université Laval, Quebec City, Quebec, Canada. 18. Landspitali University Hospital, Reykjavik, Iceland. 19. Northwestern University, Chicago, Illinois. 20. St. Thomas' Hospital, King's College London, London, UK. 21. Feinstein Institutes for Medical Research, Manhasset, New York. 22. University of Alabama at Birmingham. 23. University of Pittsburgh, Pittsburgh, Pennsylvania. 24. Lund University, Lund, Sweden. 25. Hairmyres Hospital, East Kilbride, Scotland, UK. 26. University of Amsterdam, Amsterdam, The Netherlands. 27. Hospital Clinic of Barcelona, Barcelona, Spain. 28. Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Spain. 29. Emory University, Atlanta, Georgia. 30. University of California Los Angeles, La Jolla. 31. Istanbul University, Istanbul, Turkey. 32. Medical University of South Carolina, Charleston. 33. University of Manitoba, Winnipeg, Manitoba, Canada. 34. Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 35. Hospital for Joint Diseases, New York University Seligman Center for Advanced Therapeutics, New York, New York. 36. Kantousspital, Schaffhausen, Switzerland. 37. New York University, New York, New York.
Abstract
OBJECTIVE: There is a paucity of data regarding health care costs associated with damage accrual in systemic lupus erythematosus. The present study was undertaken to describe costs associated with damage states across the disease course using multistate modeling. METHODS: Patients from 33 centers in 11 countries were enrolled in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort within 15 months of diagnosis. Annual data on demographics, disease activity, damage (SLICC/American College of Rheumatology Damage Index [SDI]), hospitalizations, medications, dialysis, and selected procedures were collected. Ten-year cumulative costs (Canadian dollars) were estimated by multiplying annual costs associated with each SDI state by the expected state duration using a multistate model. RESULTS: A total of 1,687 patients participated; 88.7% were female, 49.0% were white, mean ± SD age at diagnosis was 34.6 ± 13.3 years, and mean time to follow-up was 8.9 years (range 0.6-18.5 years). Mean annual costs were higher for those with higher SDI scores as follows: $22,006 (Canadian) (95% confidence interval [95% CI] $16,662, $27,350) for SDI scores ≥5 versus $1,833 (95% CI $1,134, $2,532) for SDI scores of 0. Similarly, 10-year cumulative costs were higher for those with higher SDI scores at the beginning of the 10-year interval as follows: $189,073 (Canadian) (95% CI $142,318, $235,827) for SDI scores ≥5 versus $21,713 (95% CI $13,639, $29,788) for SDI scores of 0. CONCLUSION: Patients with the highest SDI scores incur 10-year cumulative costs that are ~9-fold higher than those with the lowest SDI scores. By estimating the damage trajectory and incorporating annual costs, data on damage can be used to estimate future costs, which is critical knowledge for evaluating the cost-effectiveness of novel therapies.
OBJECTIVE: There is a paucity of data regarding health care costs associated with damage accrual in systemic lupus erythematosus. The present study was undertaken to describe costs associated with damage states across the disease course using multistate modeling. METHODS:Patients from 33 centers in 11 countries were enrolled in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort within 15 months of diagnosis. Annual data on demographics, disease activity, damage (SLICC/American College of Rheumatology Damage Index [SDI]), hospitalizations, medications, dialysis, and selected procedures were collected. Ten-year cumulative costs (Canadian dollars) were estimated by multiplying annual costs associated with each SDI state by the expected state duration using a multistate model. RESULTS: A total of 1,687 patients participated; 88.7% were female, 49.0% were white, mean ± SD age at diagnosis was 34.6 ± 13.3 years, and mean time to follow-up was 8.9 years (range 0.6-18.5 years). Mean annual costs were higher for those with higher SDI scores as follows: $22,006 (Canadian) (95% confidence interval [95% CI] $16,662, $27,350) for SDI scores ≥5 versus $1,833 (95% CI $1,134, $2,532) for SDI scores of 0. Similarly, 10-year cumulative costs were higher for those with higher SDI scores at the beginning of the 10-year interval as follows: $189,073 (Canadian) (95% CI $142,318, $235,827) for SDI scores ≥5 versus $21,713 (95% CI $13,639, $29,788) for SDI scores of 0. CONCLUSION:Patients with the highest SDI scores incur 10-year cumulative costs that are ~9-fold higher than those with the lowest SDI scores. By estimating the damage trajectory and incorporating annual costs, data on damage can be used to estimate future costs, which is critical knowledge for evaluating the cost-effectiveness of novel therapies.
Authors: Olena Mandrik; James Fotheringham; Shijie Ren; Jeffrey A Tice; Richard H Chapman; Matthew D Stevenson; Steven D Pearson; Serina Herron-Smith; Foluso Agboola; Praveen Thokala Journal: Clin J Am Soc Nephrol Date: 2022-02-03 Impact factor: 10.614
Authors: Ronald van Vollenhoven; Anca D Askanase; Andrew S Bomback; Ian N Bruce; Angela Carroll; Maria Dall'Era; Mark Daniels; Roger A Levy; Andreas Schwarting; Holly A Quasny; Murray B Urowitz; Ming-Hui Zhao; Richard Furie Journal: Lupus Sci Med Date: 2022-03
Authors: Alexandra Legge; Susan Kirkland; Kenneth Rockwood; Pantelis Andreou; Sang-Cheol Bae; Caroline Gordon; Juanita Romero-Diaz; Jorge Sanchez-Guerrero; Daniel J Wallace; Sasha Bernatsky; Ann E Clarke; Joan T Merrill; Ellen M Ginzler; Paul R Fortin; Dafna D Gladman; Murray B Urowitz; Ian N Bruce; David A Isenberg; Anisur Rahman; Graciela S Alarcón; Michelle Petri; Munther A Khamashta; M A Dooley; Rosalind Ramsey-Goldman; Susan Manzi; Asad A Zoma; Cynthia Aranow; Meggan Mackay; Guillermo Ruiz-Irastorza; S Sam Lim; Murat Inanc; Ronald F van Vollenhoven; Andreas Jonsen; Ola Nived; Manuel Ramos-Casals; Diane L Kamen; Kenneth C Kalunian; Søren Jacobsen; Christine A Peschken; Anca Askanase; John G Hanly Journal: Arthritis Care Res (Hoboken) Date: 2022-02-17 Impact factor: 5.178