Session Information
Title: Epidemiology and Health Services Research III: Healthcare Costs and Mortality in Rheumatic Disease
Session Type: Abstract Submissions (ACR)
Background/Purpose:
To study direct and indirect costs for patients with Systemic Lupus Erythematosus (SLE) ín five defined cohorts with nationwide spread in Sweden, and to find potential predictors of cost.
Methods:
All 1029 prevalent and incident cases of clinically confirmed SLE, all with at least 4 ACR classification criteria, being alive between January 1st 2003 and December 31st2010 and followed in cohorts in five out of seven university hospitals in Sweden were included. Demographics, date of diagnosis, follow up period, phenotype, disease activity (SLEDAI), organ-damage (ACR/SLICC DI), quality of life (EQ5D) and costs for SLE specific therapy was collected when available from the databases of the rheumatology units. The database at the National Board of Health and Welfare provided all costs for in-patient admissions, out-patient specialist visits and all drug prescriptions from July 2005, and from the Swedish Social Insurance Agency data was obtained about sick leave and disability pensions. The data merge was done within these National Institutions and the cost analysis at the Swedish Institute for Health Economics. All costs are expressed in 2011 price level.
Results:
Eighty-eight percent were females and the mean age in 2010 was 52 years with mean disease duration of 17.7 years and approximately 75 percents of the patients were below retirement age (65 years) at the end of the study period in 2010. Annual mean inpatient days were 3.1-3.6. Annual median outpatient specialist physician visits were 6.0-7.5. Annual net sick leave days decreased from 129.8 to 95.1 during the study period. The average total annual costs in SEK 2011, was per SLE patient 208 555 SEK (=$ 33 102) of which 70 percent were indirect costs, the corresponding costs for the subgroup with nephritis was 245 523 SEK (=$ 38 970). The mean annual cost for outpatient pharmaceuticals per SLE patient was 12 888 SEK (=$ 2 046 ), while the annual cost for more expensive inpatient pharmaceuticals constituted only between 10 and 20 percent of the total cost for pharmaceuticals. Predictors for total costs were increasing age from the age of 40, explained by an increase in indirect costs. Total costs increased with 39 percent for every additional point in ACR/SLICC DI and with 51 percent for patients with a SLEDAI score above 3 (All p<0.01). The EQ5D decreased with increasing SLEDAI (p<0.01). By extrapolation of the study-data the total cost for SLE in Sweden in 2011 can be estimated to 1.125 billions SEK (=$ 178 millions).
Conclusion:
The average annual cost for each SLE patient in Sweden is $ 33 102, with indirect costs representing approximately 70 percent and cost for pharmaceuticals only 7 percent of total costs. Significant and independent predictors of costs are increasing age, acquired organ damage and disease activity.
Disclosure:
A. Jönsen,
None;
A. A. Bengtsson,
None;
C. Bengtsson,
None;
I. Gunnarsson,
None;
J. Gustafsson,
None;
F. Hjalte,
None;
D. Leonard,
None;
S. Pettersson,
None;
S. Rantapää Dahlqvist,
None;
L. Rönnblom,
None;
C. Sjöwall,
None;
K. Steen Carlsson,
None;
E. Svenungsson,
None;
M. Willim,
None;
O. Nived,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/direct-and-indirect-costs-for-patients-with-systemic-lupus-erythematosus-in-national-cohorts-in-sweden/