Economic Evaluation of Damage Accrual in an International Systemic Lupus Erythematosus Inception Cohort Using a Multistate Model Approach.
Adult
Antirheumatic Agents
/ adverse effects
Cost-Benefit Analysis
Disease Progression
Drug Costs
Female
Glucocorticoids
/ adverse effects
Humans
Immunosuppressive Agents
/ adverse effects
Longitudinal Studies
Lupus Erythematosus, Systemic
/ diagnosis
Male
Middle Aged
Models, Economic
Remission Induction
Time Factors
Treatment Outcome
Young Adult
Journal
Arthritis care & research
ISSN: 2151-4658
Titre abrégé: Arthritis Care Res (Hoboken)
Pays: United States
ID NLM: 101518086
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
08
01
2019
accepted:
08
10
2019
pubmed:
15
10
2019
medline:
29
12
2020
entrez:
15
10
2019
Statut:
ppublish
Résumé
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. 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. 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. 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.
Substances chimiques
Antirheumatic Agents
0
Glucocorticoids
0
Immunosuppressive Agents
0
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1800-1808Subventions
Organisme : NIH HHS
ID : UL-1RR-025741
Pays : United States
Organisme : NIH HHS
ID : AR069572
Pays : United States
Organisme : NIH HHS
ID : R01 AR046588
Pays : United States
Organisme : NIH HHS
ID : 1U54TR001353
Pays : United States
Organisme : CIHR
ID : MOP-88526
Pays : Canada
Organisme : Arthritis Research UK
Pays : United Kingdom
Organisme : NIH HHS
ID : P60AR064464
Pays : United States
Organisme : Medical Research Council
ID : MC_UU_00002/15
Pays : United Kingdom
Organisme : NIH HHS
ID : AR43727
Pays : United States
Organisme : NIH HHS
ID : K24 AR002213
Pays : United States
Organisme : NIH HHS
ID : K24-AR-02318
Pays : United States
Organisme : Medical Research Council
ID : MC_UU_00002/8
Pays : United Kingdom
Informations de copyright
© 2020, American College of Rheumatology.
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