Economic Evaluation of Damage Accrual in an International Systemic Lupus Erythematosus Inception Cohort Using a Multistate Model Approach

Megan R W Barber; John G Hanly; Li Su; Murray B Urowitz; Yvan St Pierre; Juanita Romero-Diaz; Caroline Gordon; Sang-Cheol Bae; Sasha Bernatsky; Daniel J Wallace; Joan T Merrill; David A Isenberg; Anisur Rahman; Ellen M Ginzler; Michelle Petri; Ian N Bruce; Mary A Dooley; Paul R Fortin; Dafna D Gladman; Jorge Sanchez-Guerrero; Kristjan Steinsson; Rosalind Ramsey-Goldman; Munther A Khamashta; Cynthia Aranow; Meggan Mackay; Graciela S Alarcón; Susan Manzi; Ola Nived; Andreas Jönsen; Asad A Zoma; Ronald F van Vollenhoven; Manuel Ramos-Casals; Guillermo Ruiz-Irastorza; S Sam Lim; Kenneth C Kalunian; Murat Inanc; Diane L Kamen; Christine A Peschken; Søren Jacobsen; Anca Askanase; Vernon Farewell; Thomas Stoll; Jill Buyon; Ann E Clarke

doi:10.1002/acr.24092

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Economic Evaluation of Damage Accrual in an International Systemic Lupus Erythematosus Inception Cohort Using a Multistate Model Approach

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Economic Evaluation of Damage Accrual in an International Systemic Lupus Erythematosus Inception Cohort Using a Multistate Model Approach

Megan R W Barber, John G Hanly, Li Su, Murray B Urowitz, Yvan St Pierre, Juanita Romero-Diaz, Caroline Gordon, Sang-Cheol Bae, Sasha Bernatsky, Daniel J Wallace, …

Arthritis care & research (2010), v 72(12), pp 1800-1808

Dec 2020

DOI: https://doi.org/10.1002/acr.24092

PMID: 31609532

Featured in Collection : UN Sustainable Development Goals @ Drexel

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Abstract

Adult

Antirheumatic Agents - adverse effects

Antirheumatic Agents - economics

Antirheumatic Agents - therapeutic use

Cost-Benefit Analysis

Disease Progression

Drug Costs

Female

Glucocorticoids - adverse effects

Glucocorticoids - economics

Glucocorticoids - therapeutic use

Humans

Immunosuppressive Agents - adverse effects

Immunosuppressive Agents - economics

Immunosuppressive Agents - therapeutic use

Longitudinal Studies

Lupus Erythematosus, Systemic - diagnosis

Lupus Erythematosus, Systemic - drug therapy

Lupus Erythematosus, Systemic - economics

Male

Middle Aged

Models, Economic

Remission Induction

Time Factors

Treatment Outcome

Young Adult

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.

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Title: Economic Evaluation of Damage Accrual in an International Systemic Lupus Erythematosus Inception Cohort Using a Multistate Model Approach
Creators: Megan R W Barber - University of Calgary
John G Hanly - Queen Elizabeth II Health Sciences Centre
Li Su - University of Cambridge
Murray B Urowitz - Toronto Western Hospital
Yvan St Pierre - McGill University
Juanita Romero-Diaz - Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Caroline Gordon - University of Birmingham
Sang-Cheol Bae - Hanyang University Seoul Hospital
Sasha Bernatsky - McGill University Health Centre
Daniel J Wallace - Cedars-Sinai Medical Center
Joan T Merrill - Oklahoma Medical Research Foundation
David A Isenberg - University College London
Anisur Rahman - University College London
Ellen M Ginzler - SUNY Downstate Health Sciences University
Michelle Petri - Johns Hopkins Medicine
Ian N Bruce - University of Manchester
Mary A Dooley - University of North Carolina at Chapel Hill
Paul R Fortin - Université Laval
Dafna D Gladman - Toronto Western Hospital
Jorge Sanchez-Guerrero - Toronto Western Hospital
Kristjan Steinsson - Reykjavík University
Rosalind Ramsey-Goldman - Northwestern University
Munther A Khamashta - St Thomas' Hospital
Cynthia Aranow - Feinstein Institute for Medical Research
Meggan Mackay - Feinstein Institute for Medical Research
Graciela S Alarcón - University of Alabama at Birmingham
Susan Manzi - University of Pittsburgh
Ola Nived - Lund University
Andreas Jönsen - Lund University
Asad A Zoma - Hairmyres Hospital
Ronald F van Vollenhoven - University of Amsterdam
Manuel Ramos-Casals - Hospital Clínic de Barcelona
Guillermo Ruiz-Irastorza - University of the Basque Country
S Sam Lim - Emory University
Kenneth C Kalunian - University of California, Los Angeles
Murat Inanc - Istanbul University
Diane L Kamen - Medical University of South Carolina
Christine A Peschken - University of Manitoba
Søren Jacobsen - Copenhagen University Hospital
Anca Askanase - New York University Langone Orthopedic Hospital
Vernon Farewell - University of Cambridge
Thomas Stoll - Spitäler Schaffhausen
Jill Buyon - New York University
Ann E Clarke - University of Calgary
Publication Details: Arthritis care & research (2010), v 72(12), pp 1800-1808
Publisher: Wiley
Grant note: R01 AR046588 / NIH HHS K24-AR-02318 / NIH HHS UL-1RR-025741 / NIH HHS P60AR064464 / NIH HHS Arthritis Research UK MC_UU_00002/15 / Medical Research Council AR069572 / NIH HHS 1U54TR001353 / NIH HHS MOP-88526 / CIHR MC_UU_00002/8 / Medical Research Council
Resource Type: Journal article
Language: English
Academic Unit: General Internal Medicine
Web of Science ID: WOS:000592646300015
Scopus ID: 2-s2.0-85096776684
Other Identifier: 991021933901004721

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Collaboration types: Domestic collaboration; International collaboration
Web of Science research areas: Rheumatology

Economic Evaluation of Damage Accrual in an International Systemic Lupus Erythematosus Inception Cohort Using a Multistate Model Approach

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