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Health Care Utilization and Costs of Systemic Lupus Erythematosus by Disease Severity in the United States.
J Rheumatol. 2020 Jul 01 [Online ahead of print]JR

Abstract

OBJECTIVE

To quantify health care utilization and costs by disease severity for patients with systemic lupus erythematosus (SLE) in the United States METHODS: We conducted descriptive analyses of Humedica electronic health record (EHR) data from 2011 to 2015 (utilization analysis) and integrated Optum administrative claims/Humedica EHR data from 2012 to 2015 (cost analysis) for patients with SLE. All-cause utilization outcomes examined were hospitalizations, outpatient visits, emergency department (ED) visits, and prescription drug use. Analyses of costs stratified by disease severity were limited to patients enrolled in an Optum-participating health insurance plan for ≥1 year after the earliest observed SLE diagnosis date. Costs were converted to 2016 US dollars.

RESULTS

Health care utilization was evaluated in 17,257 patients with SLE. Averaged over the study period from 2011 to 2015, 13.7% of patients had ≥1 hospitalization per year, 25.7% had ≥1 ED visit, and 94.4% had ≥1 outpatient visit. Utilization patterns were generally similar across each year studied. Annually, 88.0% of patients had ≥1 prescription, including 1.3% who used biologics. Biologic treatment doubled between 2011 (0.7%) and 2015 (1.4%). Cost analyses included 397 patients. During 2012 to 2015, patients with severe SLE had mean annual costs of $52,951, compared with $28,936 and $21,052 for patients with moderate and mild SLE, respectively. Patients with severe SLE had increased costs in all service categories: inpatient, ED, clinic/office visits, and pharmacy.

CONCLUSION

US patients with SLE, especially individuals with moderate or severe disease, utilize significant health care resources and incur high medical costs.

Authors+Show Affiliations

From Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; AstraZeneca, Gaithersburg, MD, USA; 3AstraZeneca, Cambridge, United Kingdom. Address correspondence to Edward R. Hammond, MD, PhD, MPH, AstraZeneca, 200 Orchard Ridge Drive, Gaithersburg, MD 20878, USA. Telephone: 1-301-398-6837. E-mail: edward.hammond@astrazeneca.com.From Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; AstraZeneca, Gaithersburg, MD, USA; 3AstraZeneca, Cambridge, United Kingdom. Address correspondence to Edward R. Hammond, MD, PhD, MPH, AstraZeneca, 200 Orchard Ridge Drive, Gaithersburg, MD 20878, USA. Telephone: 1-301-398-6837. E-mail: edward.hammond@astrazeneca.com.From Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; AstraZeneca, Gaithersburg, MD, USA; 3AstraZeneca, Cambridge, United Kingdom. Address correspondence to Edward R. Hammond, MD, PhD, MPH, AstraZeneca, 200 Orchard Ridge Drive, Gaithersburg, MD 20878, USA. Telephone: 1-301-398-6837. E-mail: edward.hammond@astrazeneca.com.From Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; AstraZeneca, Gaithersburg, MD, USA; 3AstraZeneca, Cambridge, United Kingdom. Address correspondence to Edward R. Hammond, MD, PhD, MPH, AstraZeneca, 200 Orchard Ridge Drive, Gaithersburg, MD 20878, USA. Telephone: 1-301-398-6837. E-mail: edward.hammond@astrazeneca.com.From Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; AstraZeneca, Gaithersburg, MD, USA; 3AstraZeneca, Cambridge, United Kingdom. Address correspondence to Edward R. Hammond, MD, PhD, MPH, AstraZeneca, 200 Orchard Ridge Drive, Gaithersburg, MD 20878, USA. Telephone: 1-301-398-6837. E-mail: edward.hammond@astrazeneca.com.From Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; AstraZeneca, Gaithersburg, MD, USA; 3AstraZeneca, Cambridge, United Kingdom. Address correspondence to Edward R. Hammond, MD, PhD, MPH, AstraZeneca, 200 Orchard Ridge Drive, Gaithersburg, MD 20878, USA. Telephone: 1-301-398-6837. E-mail: edward.hammond@astrazeneca.com.From Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; AstraZeneca, Gaithersburg, MD, USA; 3AstraZeneca, Cambridge, United Kingdom. Address correspondence to Edward R. Hammond, MD, PhD, MPH, AstraZeneca, 200 Orchard Ridge Drive, Gaithersburg, MD 20878, USA. Telephone: 1-301-398-6837. E-mail: edward.hammond@astrazeneca.com.From Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; AstraZeneca, Gaithersburg, MD, USA; 3AstraZeneca, Cambridge, United Kingdom. Address correspondence to Edward R. Hammond, MD, PhD, MPH, AstraZeneca, 200 Orchard Ridge Drive, Gaithersburg, MD 20878, USA. Telephone: 1-301-398-6837. E-mail: edward.hammond@astrazeneca.com.From Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; AstraZeneca, Gaithersburg, MD, USA; 3AstraZeneca, Cambridge, United Kingdom. Address correspondence to Edward R. Hammond, MD, PhD, MPH, AstraZeneca, 200 Orchard Ridge Drive, Gaithersburg, MD 20878, USA. Telephone: 1-301-398-6837. E-mail: edward.hammond@astrazeneca.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32611669

Citation

Murimi, Irene B., et al. "Health Care Utilization and Costs of Systemic Lupus Erythematosus By Disease Severity in the United States." The Journal of Rheumatology, 2020.
Murimi IB, Lin DH, Kan H, et al. Health Care Utilization and Costs of Systemic Lupus Erythematosus by Disease Severity in the United States. J Rheumatol. 2020.
Murimi, I. B., Lin, D. H., Kan, H., Tierce, J., Wang, X., Nab, H., Desta, B., Alexander, G. C., & Hammond, E. R. (2020). Health Care Utilization and Costs of Systemic Lupus Erythematosus by Disease Severity in the United States. The Journal of Rheumatology. https://doi.org/10.3899/jrheum.191187
Murimi IB, et al. Health Care Utilization and Costs of Systemic Lupus Erythematosus By Disease Severity in the United States. J Rheumatol. 2020 Jul 1; PubMed PMID: 32611669.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health Care Utilization and Costs of Systemic Lupus Erythematosus by Disease Severity in the United States. AU - Murimi,Irene B, AU - Lin,Dora H, AU - Kan,Hong, AU - Tierce,Jonothan, AU - Wang,Xia, AU - Nab,Henk, AU - Desta,Barnabas, AU - Alexander,G Caleb, AU - Hammond,Edward R, Y1 - 2020/07/01/ PY - 2020/7/3/entrez JF - The Journal of rheumatology JO - J. Rheumatol. N2 - OBJECTIVE: To quantify health care utilization and costs by disease severity for patients with systemic lupus erythematosus (SLE) in the United States METHODS: We conducted descriptive analyses of Humedica electronic health record (EHR) data from 2011 to 2015 (utilization analysis) and integrated Optum administrative claims/Humedica EHR data from 2012 to 2015 (cost analysis) for patients with SLE. All-cause utilization outcomes examined were hospitalizations, outpatient visits, emergency department (ED) visits, and prescription drug use. Analyses of costs stratified by disease severity were limited to patients enrolled in an Optum-participating health insurance plan for ≥1 year after the earliest observed SLE diagnosis date. Costs were converted to 2016 US dollars. RESULTS: Health care utilization was evaluated in 17,257 patients with SLE. Averaged over the study period from 2011 to 2015, 13.7% of patients had ≥1 hospitalization per year, 25.7% had ≥1 ED visit, and 94.4% had ≥1 outpatient visit. Utilization patterns were generally similar across each year studied. Annually, 88.0% of patients had ≥1 prescription, including 1.3% who used biologics. Biologic treatment doubled between 2011 (0.7%) and 2015 (1.4%). Cost analyses included 397 patients. During 2012 to 2015, patients with severe SLE had mean annual costs of $52,951, compared with $28,936 and $21,052 for patients with moderate and mild SLE, respectively. Patients with severe SLE had increased costs in all service categories: inpatient, ED, clinic/office visits, and pharmacy. CONCLUSION: US patients with SLE, especially individuals with moderate or severe disease, utilize significant health care resources and incur high medical costs. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/32611669/Health_Care_Utilization_and_Costs_of_Systemic_Lupus_Erythematosus_by_Disease_Severity_in_the_United_States L2 - http://www.jrheum.org/cgi/pmidlookup?view=long&pmid=32611669 DB - PRIME DP - Unbound Medicine ER -
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