Systemic lupus erythematosus and associated healthcare resource consumption in selected cities from the Russian Federation, Republic of Kazakhstan and Ukraine: the ESSENCE study

Abstract

Objectives: To evaluate healthcare resource (HR) consumption associated with Systemic Lupus Erythematosus (SLE) management in adult patients with active autoantibody positive disease in the Russian Federation, Republic of Kazakhstan, and Ukraine.

Methods: The ESSENCE was a retrospective, observational study, and included data on patients’ clinical characteristics and SLE-related HR use (laboratory, biopsy, imaging tests, medications, visits to specialists, outpatient visits, hospitalizations) during 2010 from the 12 specialized rheumatologic centers.

Results: A total of 436 SLE patients were included in the analyses, with 232 patients being enrolled in Russia, 110 in Kazakhstan, and 94 in Ukraine. The mean age was 36–42 years and median SLE duration was 3–6.8 years across the countries. Extrapolation to total country population showed that, in 2010, visits to specialists (who assign treatment for organs involved/damaged by SLE) were the most frequently used HR (from 13,439 visits in Kazakhstan to 23,510 in Russia), followed by hospitalizations (from 2,950 in Kazakhstan to 6,267 in Russia) and outpatient visits (from 1,654 visits in Russia to 8,064 in Kazakhstan). Compared to chronic active patients (SLE persistent during last year), patients with relapsing-remitting SLE (at least one flare alternated by one remission per year) had a higher rate of visits to specialists (100% vs 60.8%, p < .001) and hospitalizations (98.9% vs 60.8%, p < .001). Compared to patients without flares, patients experiencing flares had a higher rate of unplanned visits to specialists (86.2% vs 6.3%, p < .001), were more often hospitalized (both ICU and non-ICU) (100.0% vs 50.0%, p < .001), and had a longer duration of ICU hospitalization (25.9 days vs 17.5 days, p < .001).

Conclusions: Specialist visits are the most frequently consumed SLE-related healthcare recourse in the Commonwealth of Independent States (CIS) countries. A relapsing-remitting SLE profile and the occurrence of flares significantly raise healthcare resource consumption.

Keywords:

• Systemic Lupus Erythematosus
• SLE
• healthcare resource consumption
• Russia
• Kazakhstan
• Ukraine

JEL classification codes:

• H51
• I12

Transparency

Declaration of funding

The funding for the study was provided by GlaxoSmithKline, Brentford, Middlesex, UK.

Declaration of financial/other relationships

AG reports having received personal fees from GlaxoSmithKline, during the conduct of the study; personal fees from GlaxoSmithKline and Novartis Pharma, outside the submitted work. OI reports having received personal fees from GlaxoSmithKline, during the conduct of the study; personal fees from GlaxoSmithKline, MSD, Abbott, Servier, and Roche, outside the submitted work. S. Shevchuk reports having received personal fees from GlaxoSmithKline, during the conduct of the study; personal fees from AstraZeneca and Boehringer Ingelheim, outside the submitted work. EN, S. Soloviev, AL, RI, GT, CB, and ZhO reported receiving Investigators grant fee from GlaxoSmithKline. AV and JM are employed by GlaxoSmithKline. JD and LT are employed by and own stock in GlaxoSmithKline. Peer reviewers on this manuscript have received an honorarium from JME for their review work, but have no other relevant financial relationships to disclose.

Data availability statement

Information related to the study is available at: http://www.gsk-clinicalstudyregister.com/. GlaxoSmithKline eTrack study identifier: EPI116387. GlaxoSmithKline study acronym: ESSENCE.

Ethics approval

The study was reviewed and approved by Independent Ethic Committees in each country according to the local requirements (Russia: The Independent Interdisciplinary Ethics Committee of Ethical Review for Clinical Trials; Ukraine: Central Commission on Ethics of the Ministry of Health of Ukraine; Kazakhstan: Central Ethics Committee of the Ministry of Health of Kazakhstan). The study followed local data protection laws; patient and data confidentiality were respected.

Acknowledgments

We thank all investigators for their contribution to the study, allowing the first clinical epidemiology research in SLE to happen in Russia and CIS countries with a high level of integrity and the contract research organization, Synergy Research Group, which was funded by GlaxoSmithKline, performing the study organization and conduct. All authors acknowledge editorial support in the form of production of draft outline, editorial suggestions to draft versions of this paper, collating author comments, assembling tables and figures, referencing, and copyediting by Caroline Wirtzbiki at GlaxoSmithKline and Julia She at Synergy Research Group. Patient consent was obtained.