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Economic Evaluation of Damage Accrual in an International Systemic Lupus Erythematosus Inception Cohort Using a Multistate Model Approach.
Barber, Megan R W; Hanly, John G; Su, Li; Urowitz, Murray B; St Pierre, Yvan; Romero-Diaz, Juanita; Gordon, Caroline; Bae, Sang-Cheol; Bernatsky, Sasha; Wallace, Daniel J; Merrill, Joan T; Isenberg, David A; Rahman, Anisur; Ginzler, Ellen M; Petri, Michelle; Bruce, Ian N; Dooley, Mary A; Fortin, Paul R; Gladman, Dafna D; Sanchez-Guerrero, Jorge; Steinsson, Kristjan; Ramsey-Goldman, Rosalind; Khamashta, Munther A; Aranow, Cynthia; Mackay, Meggan; Alarcón, Graciela S; Manzi, Susan; Nived, Ola; Jönsen, Andreas; Zoma, Asad A; van Vollenhoven, Ronald F; Ramos-Casals, Manuel; Ruiz-Irastorza, Guillermo; Lim, S Sam; Kalunian, Kenneth C; Inanc, Murat; Kamen, Diane L; Peschken, Christine A; Jacobsen, Søren; Askanase, Anca; Farewell, Vernon; Stoll, Thomas; Buyon, Jill; Clarke, Ann E.
Afiliação
  • Barber MRW; University of Calgary, Alberta, Canada.
  • Hanly JG; Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada.
  • Su L; University of Cambridge, Cambridge, UK.
  • Urowitz MB; Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada.
  • St Pierre Y; Research Institute of the McGill University Health Center, Montreal, Quebec, Canada.
  • Romero-Diaz J; Instituto Nacional de Ciencias Médicas y Nutricion, Mexico City, Mexico.
  • Gordon C; University of Birmingham, Birmingham, UK.
  • Bae SC; Hanyang University Hospital for Rheumatic Diseases, Seoul, Republic of Korea.
  • Bernatsky S; McGill University Health Centre, Montreal, Quebec, Canada.
  • Wallace DJ; Cedars-Sinai Medical Center and University of California, Los Angeles.
  • Merrill JT; Oklahoma Medical Research Foundation, Oklahoma City.
  • Isenberg DA; University College London, London, UK.
  • Rahman A; University College London, London, UK.
  • Ginzler EM; State University of New York Downstate Medical Center, Brooklyn.
  • Petri M; Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Bruce IN; Manchester Academic Health Sciences Centre, University of Manchester and Central Manchester University Hospitals National Health Service Foundation Trust, Manchester, UK.
  • Dooley MA; University of North Carolina, Chapel Hill.
  • Fortin PR; CHU de Québec, Université Laval, Quebec City, Quebec, Canada.
  • Gladman DD; Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada.
  • Sanchez-Guerrero J; Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada.
  • Steinsson K; Landspitali University Hospital, Reykjavik, Iceland.
  • Ramsey-Goldman R; Northwestern University, Chicago, Illinois.
  • Khamashta MA; St. Thomas' Hospital, King's College London, London, UK.
  • Aranow C; Feinstein Institutes for Medical Research, Manhasset, New York.
  • Mackay M; Feinstein Institutes for Medical Research, Manhasset, New York.
  • Alarcón GS; University of Alabama at Birmingham.
  • Manzi S; University of Pittsburgh, Pittsburgh, Pennsylvania.
  • Nived O; Lund University, Lund, Sweden.
  • Jönsen A; Lund University, Lund, Sweden.
  • Zoma AA; Hairmyres Hospital, East Kilbride, Scotland, UK.
  • van Vollenhoven RF; University of Amsterdam, Amsterdam, The Netherlands.
  • Ramos-Casals M; Hospital Clinic of Barcelona, Barcelona, Spain.
  • Ruiz-Irastorza G; Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Spain.
  • Lim SS; Emory University, Atlanta, Georgia.
  • Kalunian KC; University of California Los Angeles, La Jolla.
  • Inanc M; Istanbul University, Istanbul, Turkey.
  • Kamen DL; Medical University of South Carolina, Charleston.
  • Peschken CA; University of Manitoba, Winnipeg, Manitoba, Canada.
  • Jacobsen S; Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
  • Askanase A; Hospital for Joint Diseases, New York University Seligman Center for Advanced Therapeutics, New York, New York.
  • Farewell V; University of Cambridge, Cambridge, UK.
  • Stoll T; Kantousspital, Schaffhausen, Switzerland.
  • Buyon J; New York University, New York, New York.
  • Clarke AE; University of Calgary, Alberta, Canada.
Arthritis Care Res (Hoboken) ; 72(12): 1800-1808, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31609532
ABSTRACT

OBJECTIVE:

There is a paucity of data regarding health care costs associated with damage accrual in systemic lupus erythematosus. The present study was undertaken to describe costs associated with damage states across the disease course using multistate modeling.

METHODS:

Patients from 33 centers in 11 countries were enrolled in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort within 15 months of diagnosis. Annual data on demographics, disease activity, damage (SLICC/American College of Rheumatology Damage Index [SDI]), hospitalizations, medications, dialysis, and selected procedures were collected. Ten-year cumulative costs (Canadian dollars) were estimated by multiplying annual costs associated with each SDI state by the expected state duration using a multistate model.

RESULTS:

A total of 1,687 patients participated; 88.7% were female, 49.0% were white, mean ± SD age at diagnosis was 34.6 ± 13.3 years, and mean time to follow-up was 8.9 years (range 0.6-18.5 years). Mean annual costs were higher for those with higher SDI scores as follows $22,006 (Canadian) (95% confidence interval [95% CI] $16,662, $27,350) for SDI scores ≥5 versus $1,833 (95% CI $1,134, $2,532) for SDI scores of 0. Similarly, 10-year cumulative costs were higher for those with higher SDI scores at the beginning of the 10-year interval as follows $189,073 (Canadian) (95% CI $142,318, $235,827) for SDI scores ≥5 versus $21,713 (95% CI $13,639, $29,788) for SDI scores of 0.

CONCLUSION:

Patients with the highest SDI scores incur 10-year cumulative costs that are ~9-fold higher than those with the lowest SDI scores. By estimating the damage trajectory and incorporating annual costs, data on damage can be used to estimate future costs, which is critical knowledge for evaluating the cost-effectiveness of novel therapies.
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Avaliação econômica em saúde Idioma: Inglês Revista: Arthritis Care Res (Hoboken) Assunto da revista: Reumatologia Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Canadá

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Avaliação econômica em saúde Idioma: Inglês Revista: Arthritis Care Res (Hoboken) Assunto da revista: Reumatologia Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Canadá
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