gms | German Medical Science

Introduction: Irreversible organ damage (OD) occurs in 33-54% of patients with systemic lupus erythematosus (SLE) within 5 years of diagnosis [1], [2], [3]. There are limited real-world studies on the economic burden of SLE long-term OD. This study assessed the healthcare costs of OD in adults with SLE.

Methods: This noninterventional retrospective cohort study (GSK Study 209523) used administrative claims data of the statutory health system from the Betriebskrankenkassen German Sickness Fund Database. Eligible adults were identified by an SLE diagnosis code (with ≥1 inpatient SLE claim; or ≥1 outpatient SLE claim, therapy prescription and physician specialty) during the inclusion period (January 2009 to December 2014), with additional criteria for duration of enrollment. Controls comprised randomly selected individuals without SLE diagnosis, propensity score-matched (1:3 [SLE:controls]) to patients in the SLE cohort by age, sex, and comorbidities in the Charlson comorbidity index. Controls were assigned the index and end of follow-up dates of their matched patient with an SLE diagnosis. An algorithm to identify OD was developed based on the SLICC/ACR Damage Index, using ICD diagnostic codes, healthcare procedures, and treatments. Total annual per person-year (PY) costs were compared using the paired Wilcoxon test.

Results: The mean (standard deviation [SD]) age of patients with SLE was 50.9 (16.18) years versus 51.4 (9.39) years in controls, with a mean (SD) follow-up of 6.4 (2.05) years. OD was identified in 83.0% of patients with SLE and 66.5% of controls. Among incident patients with SLE (n=1084), 55.3% had OD prior to the index SLE diagnosis; for prevalent patients (n=1037) this value was 66.0%. The largest difference between the SLE (N=2121) and control cohort (N=6308) was observed in cutaneous damage (20.7% vs 2.0%, respectively), followed by cardiovascular (29.0% vs 19.3%). Expenditure for patients with SLE and OD exceeded double that of those without OD (Year 1: 8318€ vs 3808€; Figure 1 [Fig. 1]). The difference in expenditure between patients with SLE with and without OD increased over time, reaching a factor of 3.2 in Year 6.

Conclusion: Over 80% of the patients with SLE had OD during the study period, which was associated with significant economic burden.

Acknowledgements: This study (209523) was funded by GSK. Medical writing support was provided by Casmira Brazaitis, PhD, of Fishawack Indicia Ltd., UK, part of Fishawack Health, and was funded by GSK.

Disclosure Statement: MS and MP are employees of Kantar Health, which was contracted by GSK to conduct this study. EGP is an employee of Team Gesundheit GmbH and has nothing to disclose. HC, KG, and RAL are employees of GSK and hold stocks and shares in the company.