TY - JOUR
T1 - Economic Evaluation of Damage Accrual in an International Systemic Lupus Erythematosus Inception Cohort Using a Multistate Model Approach
AU - Barber, Megan R.W.
AU - Hanly, John G.
AU - Su, Li
AU - Urowitz, Murray B.
AU - St. Pierre, Yvan
AU - Romero-Diaz, Juanita
AU - Gordon, Caroline
AU - Bae, Sang Cheol
AU - Bernatsky, Sasha
AU - Wallace, Daniel J.
AU - Merrill, Joan T.
AU - Isenberg, David A.
AU - Rahman, Anisur
AU - Ginzler, Ellen M.
AU - Petri, Michelle
AU - Bruce, Ian N.
AU - Dooley, Mary A.
AU - Fortin, Paul R.
AU - Gladman, Dafna D.
AU - Sanchez-Guerrero, Jorge
AU - Steinsson, Kristjan
AU - Ramsey-Goldman, Rosalind
AU - Khamashta, Munther A.
AU - Aranow, Cynthia
AU - Mackay, Meggan
AU - Alarcón, Graciela S.
AU - Manzi, Susan
AU - Nived, Ola
AU - Jönsen, Andreas
AU - Zoma, Asad A.
AU - van Vollenhoven, Ronald F.
AU - Ramos-Casals, Manuel
AU - Ruiz-Irastorza, Guillermo
AU - Lim, S. Sam
AU - Kalunian, Kenneth C.
AU - Inanc, Murat
AU - Kamen, Diane L.
AU - Peschken, Christine A.
AU - Jacobsen, Søren
AU - Askanase, Anca
AU - Farewell, Vernon
AU - Stoll, Thomas
AU - Buyon, Jill
AU - Clarke, Ann E.
N1 - Publisher Copyright:
© 2020, American College of Rheumatology
PY - 2020/12
Y1 - 2020/12
N2 - 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.
AB - 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.
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U2 - 10.1002/acr.24092
DO - 10.1002/acr.24092
M3 - Article
C2 - 31609532
AN - SCOPUS:85096776684
SN - 2151-464X
VL - 72
SP - 1800
EP - 1808
JO - Arthritis Care and Research
JF - Arthritis Care and Research
IS - 12
ER -