Background/Purpose:

To study the annual direct and indirect costs in SLE in a cohort, from a defined area in southern Sweden, and to find potential predictors of cost.

Methods: All 127 prevalent and incident cases of clinically confirmed SLE, all with at least 4 ACR classification criteria, being alive between January 1^st 2003 and December 31^st 2010 in a defined area with an adult population of 175.000, were included.  Demographics, date of diagnosis, follow up period, phenotype, disease activity (SLEDAI), organ-damage (ACR/SLICC DI) and costs for SLE specific therapy was collected from the database of the rheumatology unit. From the population registry 508 individuals matched for age and sex constituted a reference group. For both cases and references the local Health Authorities database provided all costs for in-patient admissions, out-patient care with all types of health care personnel, and from the Swedish Social Security Agency data was obtained about sick leave and disability pensions. The data merge was done within the Epi-Centrum in Lund and the cost analysis at the Swedish Institute for Health Economics.   

Results:

Eighty-seven percent were females and the mean age in 2003 was 52 years with mean disease duration of 16 years and the total observed years were 869 for the patients and 4064 for the references.  Annual median inpatient days for cases were 2.91, for subgroup with nephritis 5.68 and for references 0.70. Annual outpatient physician visits were for cases 6.25, for subgroup with nephritis 6.25 and for references 2.40. Annual net sick leave days for cases were 99.9, for subgroup with nephritis 111.6 and for references 35.6. The average total annual costs in SEK 2011, was per SLE patient 180 520 SEK (=$ 25 072) of which 72 percent were indirect costs, the corresponding costs for the subgroup with nephritis was 229 423 SEK  (=$ 31 864) and for the references 59 985 SEK (=$ 8 331) of which 78 percent were indirect costs. Potential predictors of total costs were age at study year (p=0.001), disease activity measured by SLEDAI (p<0.001) and organ-damage measured by ACR/SLICC DI (p<0.001).

Conclusion:

: Disease burden for SLE was significantly increased compared with matched population references both for contacts with health care and loss of productivity, with indirect costs constituting 72 percent. Independent predictors of costs were age, disease activity and organ-damage.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/disease-burden-and-cost-of-illness-in-sle-during-8-years-follow-up/