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Healthcare Costs and Utilization for Patients With Systemic Lupus Erythematosus in China: A National Claims Database
Xin He1, Emily Lloyd2, Selin Cooper2
1Value, Evidence and Outcomes, GSK, Shanghai, China.
Insights
Systemic lupus erythematosus (SLE) in China incurs significant healthcare costs, particularly during severe flares. Reducing flares, infections, and hospitalizations can lower the financial burden for patients and healthcare systems.
Area of Science:
- Rheumatology
- Health Economics
- Public Health
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with significant global health implications.
- Understanding the economic burden of SLE is crucial for resource allocation and policy development.
Purpose of the Study:
- To quantify healthcare resource utilization (HCRU) and costs associated with SLE management in China.
- To analyze SLE costs from both patient and payer perspectives.
Main Methods:
- Utilized national medical insurance claims data from China Health Insurance Research Association (2017).
- Included adult patients with at least one SLE-related claim.
- Analyzed overall and annual subgroups for HCRU and costs.
Main Results:
- Outpatient visits comprised 86.9% of healthcare encounters.
- Average costs were USD 433 per outpatient and USD 2072 per inpatient.
- Severe SLE flares (35.4% of patients) incurred a mean cost of USD 1616.
- Higher costs were linked to female sex, SLE flares, tertiary hospitals, renal involvement, and anti-infective drug use.
Conclusions:
- SLE management in China presents a substantial HCRU and financial burden.
- Preventive strategies targeting organ involvement, infections, and flares are essential to mitigate costs.
- Reducing hospitalizations can alleviate the economic strain on patients and healthcare providers.
Objectives:
This study aimed to describe the healthcare resource utilization (HCRU) and healthcare costs associated with systemic lupus erythematosus (SLE) management in China from the patient's and the payer's perspective.
Methods:
HCRU and medical costs (2017 US dollar [USD]) between January 1 and December 31, 2017, were extracted from the national medical insurance claims database, China Health Insurance Research Association (consisting of claims from all public health insurance schemes in China), for adults with ≥ 1 SLE-related claim. The main analysis group comprised all adults with an SLE diagnosis and claim during 2017 (overall group); the annual subgroup (SLE diagnosis and claim in January 2017) informed annual HCRU and costs.
Results:
The overall group consisted of 3645 adults with ≥ 1 SLE-related claim. Outpatient visits constituted 86.9% of healthcare visits. SLE-related healthcare outpatient costs were USD 433 per outpatient, and inpatient costs were USD 2072 per inpatient. Medication costs accounted for 75.0% (USD 42/56) of total costs for outpatient visits and 44.3% (USD 456/1030) for inpatient hospitalizations. Notably, 35.4% of patients had a severe SLE flare; mean SLE-related cost per severe flare was USD 1616. HCRU and costs were similar in the annual subgroup. Female sex, SLE flares, tertiary hospitals, renal involvement, and utilization of anti-infective drugs were associated with higher SLE-related patient costs.
Conclusions:
SLE in China is associated with considerable HCRU and medical costs, especially for patients experiencing severe SLE flares. Preventing organ involvement, infections, flares, and associated hospitalizations may reduce the burden on patients and healthcare providers in China.
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