Direct cost of management and treatment of active systemic lupus erythematosus and its flares in Spain: The LUCIE Study

Cervera, R.; Rúa-Figueroa, I.; Gil-Aguado, A.; Sabio, J.M.; Pallarés, L.; Hernández-Pastor, L.J.; Iglesias, M.

doi:10.1016/j.rceng.2013.03.001

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Tables (6)

Table 1. Demographic and clinical characteristics of the included patients.

Table 2. Description of the use of healthcare resources employed over the 2-year course of the study.

Table 3. Direct costs associated with the healthcare resources used annually for patients with SLE.

Table 4. Characterization of flare-ups in study patients during the 2-year follow-up.

Table 5. Description of the use of healthcare resources associated with flare-ups during the 2-year study period.

Table 6. Distribution of the direct annual costs associated with healthcare resources related to SLE flare-ups.

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Abstract

Background and objective

The cost of control and management of systemic lupus erythematosus (SLE) in Spain is unknown. This study has aimed to describe the healthcare resources associated to control and treatment of LES and its flares and to estimate the associated direct costs.

Patients and methods

This was a European, multicentric, retrospective study (2008–2010) carried out with the participation of 5 hospitals in Spain with experience in SLE. Adult SLE patients (ACR criteria), with positive auto-antibodies (ANA and/or anti-ds-DNA) and active disease were included. Patients were stratified into severe and non-severe SLE. Direct healthcare costs were estimated with resources used and their unit costs.

Results

Seventy-five out of 79 SLE patients were analyzed. Of these, 52% had severe disease, 91.9% were females and 90.7% were Caucasian. Mean (SD) age was 41.0 (14.5) years. Annual direct cost per patient related to SLE management was €5968 (7038) and €3604 (5159) for severe and non-severe patients, respectively (p=0.002). Costs related to hospitalizations, pharmacological treatment, visits to specialists, and laboratory tests were higher for patients with severe disease. At least one flare during the observation period was present in 90.7% of patients. Severe flares were a significant predictor of increase in cost.

Conclusions

The cost associated with SLE control and treatment is higher for severe SLE patients. Insufficient control of the disease activity results in an increase in flares. Its presence is related to an increase in costs, hospitalization being the major component.

Keywords:

Systemic lupus erythematosus

Disease activity

Health resources

Healthcare resources cost

Resumen

Fundamento y objetivo

El coste del control y el tratamiento del lupus eritematoso sistémico (LES) en España es desconocido. El objetivo del estudio fue describir los recursos sanitarios asociados al control y el tratamiento del LES y sus brotes, y estimar el coste directo asociado.

Pacientes y método

Estudio retrospectivo (2008–2010) europeo con participación de 5 centros españoles con experiencia en LES. Se incluyeron pacientes adultos con LES (criterios ACR) con autoanticuerpos positivos (ANA y/o anti-ADN nativo), en tratamiento médico y enfermedad activa. Los pacientes se estratificaron en graves y no graves. Los costes sanitarios directos se estimaron a partir de los recursos utilizados y de sus costes unitarios.

Resultados

Se analizaron 75 de 79 pacientes españoles incluidos (52% graves). El 91,9% fueron mujeres y el 90,7% caucásicos. La edad media (DE) fue de 41 (14,5) años. El coste anual por paciente asociado al LES fue de 5.968€ (7.038) y 3.604€ (5.159) en pacientes graves y no graves, respectivamente (p=0,002). Los costes asociados con hospitalizaciones, tratamiento farmacológico, visitas al especialista y pruebas de laboratorio fueron superiores en pacientes con LES grave. El 90,7% de los pacientes presentó, al menos, un brote en 2 años. Los brotes graves fueron un predictor significativo del incremento del coste.

Conclusiones

El coste asociado al control y el tratamiento del LES es mayor en pacientes con LES grave. El insuficiente control de la actividad de la enfermedad se traduce en la aparición de brotes, cuya presencia se relaciona con un incremento de costes, siendo los relativos a las hospitalizaciones el componente mayoritario.

Palabras clave:

Lupus eritematoso sistémico

Actividad de la enfermedad

Recursos sanitarios

Coste de los recursos sanitarios

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