The economic burden of systemic lupus erythematosus in commercially- and medicaid-insured populations in the United States
| Autor: | Shaum M Kabadi, Ann E. Clarke, Emily Durden, Kirstin Griffing, Jinoos Yazdany, I. Winer, Karen H. Costenbader |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Healthcare utilization Databases Factual Psychological intervention Medication Severity of Illness Index Cohort Studies 0302 clinical medicine immune system diseases Lupus Erythematosus Systemic 030212 general & internal medicine skin and connective tissue diseases health care economics and organizations Systemic lupus erythematosus Health Care Costs Middle Aged Health Services Health 6.1 Pharmaceuticals Public Health and Health Services Female Adult medicine.medical_specialty Combination therapy Clinical Sciences Lupus Pharmacy Autoimmune Disease Article Severity 03 medical and health sciences Databases Insurance Rheumatology Disease severity Clinical Research Statistical significance Internal medicine medicine Humans Factual 030203 arthritis & rheumatology Insurance Health Lupus Erythematosus business.industry Medicaid Inflammatory and immune system Systemic Evaluation of treatments and therapeutic interventions Healthcare costs medicine.disease United States Arthritis & Rheumatology Anesthesiology and Pain Medicine Good Health and Well Being business |
| Zdroj: | Seminars in arthritis and rheumatism, vol 50, iss 4 Semin Arthritis Rheum |
| Popis: | ObjectiveTo estimate the economic burden of systematic lupus erythematous (SLE), stratified by disease severity, in commercially- and Medicaid-insured US populations.MethodsAdults (≥18 years) with SLE treated with antimalarials, selected biologics, immunosuppressants, and systemic glucocorticoids (2010-2014) were identified within the commercial and Medicaid insurance IBM MarketScan® databases (index date=first SLE medication claim). Both cohorts were stratified into mild (receiving antimalarial or glucocorticoid monotherapy ≤5 mg/day) versus moderate/severe SLE (receiving glucocorticoids >5 mg/day, biologic, immunosuppressant, or combination therapy) during a 6-month exposure period. All-cause healthcare utilization and costs were evaluated during the 12 months following the exposure period.ResultsAmong 8231 commercially-insured patients, 32.6% had mild and 67.4% had moderate/severe SLE by our definition. Among 802 Medicaid-insured patients, 25.2% had mild and 74.8% had moderate/severe SLE. Adjusted mean total healthcare costs, excluding pharmacy, for moderate/severe SLE patients were higher than for mild SLE patients in the commercially-insured ($39,021 versus $23,519; p < 0.0001) and Medicaid-insured populations ($56,050 versus $44,932; p=0.06). In both SLE severity populations total unadjusted costs were significantly higher among Medicaid-insured than commercially-insured patients.ConclusionCommercially-insured patients with treatment suggesting moderate/severe SLE incurred significantly higher adjusted mean healthcare costs, excluding pharmacy, compared with mild SLE patients. While not reaching statistical significance, moderate/severe Medicaid-insured patients had higher costs then mild SLE patients. Total unadjusted healthcare costs were significantly higher among Medicaid-insured than commercially-insured patients. These differential costs are important to consider and monitor when implementing interventions to improve health and reduce healthcare spending for SLE. |
| Databáze: | OpenAIRE |
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