Abstract
This study aimed to describe the clinical burden, healthcare resource utilisation (HCRU) and healthcare costs for patients with systemic lupus erythematosus (SLE) in the 12-60months preceding an end-stage kidney disease (ESKD) diagnosis in the USA. This retrospective observational study identified adult patients with SLE with newly diagnosed ESKD between 1March 2012 and 31December 2018 using administrative claims data. Clinical characteristics, mean all-cause HCRU (i.e. any HCRU visit and pharmacy fill) and total all-cause healthcare costs (comprising medical and pharmacy costs in 2019 US dollars) were assessed during the 12months pre-ESKD diagnosis and yearly during the 5years pre-ESKD diagnosis among patients with ≥ 5years of continuous health plan enrolment. Of the 1356 patients included, 51.2% had severe SLE, 71.2% had lupus nephritis (LN) and 20.6% underwent kidney biopsy during the 12months pre-ESKD. The mean (standard deviation [SD]) number of HCRU visits during the 12months pre-ESKD was 78.0 (64.1) per patient. The mean (SD) total healthcare costs per patient in the 12months pre-ESKD diagnosis was $64,887 (106,822), driven by medical costs $51,764 (96,458). The proportions of patients with severe SLE, LN and those undergoing biopsy increased from year5 to year1 pre-ESKD diagnosis. The mean (SD) number of HCRU visits increased from year5 (61.6 [54.0]) to year1 (83.2 [62.1]) pre-ESKD. Mean (SD)total healthcare costs rose year on year from year5 ($34,890 [74,346]) to year1 ($73,236 [114,584]) pre-ESKD. There were substantial clinical burden and healthcare costs among patients with SLE in the 12months pre-ESKD diagnosis. The clinical burden and healthcare costs generally increased with each year approaching ESKD diagnosis. Early interventions for patients with SLE could prevent the development of ESKD, mitigating the burden of the disease.
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