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Clinical profile and direct medical cost of care of adults presenting with systemic lupus erythematosus in Italy

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11

 

  1. Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy.
  2. Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy.
  3. Rheumatology Unit, Second University of Napoli, Napoli, Italy.
  4. Division of Rheumatology, Department of Medical Sciences, University of Cagliari, Cagliari, Italy.
  5. Division of Rheumatology, Department of Medical Sciences, University of Cagliari, Cagliari, Italy.
  6. Department of Rheumatology, Ospedale Santa Maria alle Scotte, University of Siena, Siena, Italy.
  7. Department of Rheumatology, Ospedale Santa Maria alle Scotte, University of Siena, Siena, Italy.
  8. HEOR, Real-World Evidence Solutions (RWES) unit, IMS Health, Paris-La Défense, France.
  9. HEOR, Real-World Evidence Solutions (RWES) unit, IMS Health, Paris-La Défense, France.
  10. Immuno-Inflammation & Infectious Diseases (II-ID) Global Franchise, GlaxoSmithKline, London, UK.
  11. Speciality Care Medical Department, GlaxoSmithKline, Verona, Italy.

CER7569
2015 Vol.33, N°3
PI 0375, PF 0384
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PMID: 26005879 [PubMed]

Received: 04/05/2014
Accepted : 08/01/2015
In Press: 25/05/2015
Published: 22/06/2015

Abstract

OBJECTIVES:
To determine the clinical profile and estimate the annual direct medical cost of care of adult patients with active, autoantibody positive systemic lupus erythematosus (SLE) in Italy.
METHODS:
A two-year, retrospective, multicentre, observational study was conducted from January to May 2011. Patients’ characteristics, SLE disease activity and severity, rate of flares, healthcare consumption (e.g. medications, etc.) were evaluated. Medical costs were assessed from the Italian National Health Insurance perspective.
RESULTS:
Four centres enrolled 96 eligible patients, including 85.4% women. Patients were equally stratified per disease severity (severe SLE: 51%). The mean (SD) age was 42.9 (13.8) years. At baseline, SLE duration was 12.6 (7.2) years. The mean (SD) SELENA-SLEDAI score was higher in severe than in non-severe patients 9.2 (6.4) vs. 3.3 (3.1) (p<0.001). The mean (SD) SLICC/ACR index score was similar in the two subgroups: 0.4 (0.8) vs. 0.3 (0.8). Over the study period, severe patients experienced on average 0.73 (0.56) flares/year and non-severe patients 0.57 (0.63). The annual medical cost was 1.6 times higher in severe than in non-severe patients (€2,101 vs. €1,320; p=0.031). The cost of medications was also 2.5 times higher in severe patients (€1101 vs. €445, p=0.007). Low C3/C4 complement levels and each severe flare incremented the annual cost of €550 (p=0.011) and €465 (p=0.02), respectively.
CONCLUSIONS:
The medical cost of SLE in Italy is related to disease severity and flares. Medications identified as the main cost drivers, and low C3/C4 complement levels and severe flares as the main cost predictors, increased significantly the cost of SLE management.

Rheumatology Article