Clinical and economic burden of systemic lupus erythematosus in Colombia

Abstract

Aims

Our cost-of-illness (COI) model adopted payer and societal perspectives over five years to measure the economic burden of Systemic Lupus Erythematosus (SLE) in Colombia.

Materials and methods

A prevalence-based model was constructed to estimate costs and economic consequences for SLE patients in Colombia. The model included four health states: three phenotypes of SLE representing mild, moderate, and severe states and death. The clinical inputs were captured from the published literature and validated by the Delphi panel. Our model measured direct medical and indirect costs, including disease management, transient events, and indirect costs. One-way sensitivity analysis was also performed.

Results

The number of Colombian SLE patients was 37,498. The number of SLE patients with mild, moderate, and severe phenotypes was 5343, 28757 and 3,397, respectively. SLE-patients with moderate (Colombian pesos; COP 146 billion) and severe phenotypes (COP276 billion) incurred higher costs than those with mild phenotypes (COP2 billion), over 5 years. The total SLE cost in Colombia over five years from the payer and societal perspectives was estimated to be COP 915 billion and 8 trillion, respectively. The costs per patient per year from the payer and societal perspectives were COP 4,881,902 ($3,510) and COP 46,637,054 ($33,528), respectively.

Conclusion

The burden of SLE in Colombia over five years is substantially high, mainly due to the consequences of economic loss because it affects women and men of working age, in addition to the costs of SLE management and its consequences, such as flares, infection, and organ damage. Our COI indicated that disease management costs among patients with moderate and severe SLE were substantially higher than those among patients with a mild phenotype. Therefore, more attention should be paid to limiting the progression of SLE and the occurrence of flares, with the need for further economic evaluation of novel treatment strategies that help in disease control.

Keywords:

• Colombia
• SLE
• costs
• economic burden
• consequences

JEL Classification Codes:

• C51
• C5
• C
• H51
• H5
• H

Transparency

Declaration of funding

This study was funded by AstraZeneca, who had no involvement in the study design, analysis, interpretation of results or manuscript writing. The funding received was used to pay for the submission and the open access publication fees.

Declaration of financial/other relationships

GE was employed by HTA Office, LLC. GE is a speaker for Janssen, Merck, Novartis, AstraZeneca, Roche, Eva pharma and Pfizer. The authors have no other financial relationships to disclose. The experts did not receive any compensation for their participation in the Delphi panel.

Author contributions

GE, GQ involved in conception and design, PS involved in interpretation of the data; GE draft the paper, DF, GQ revised it critically for intellectual content; and the final approval of the version to be published; and that all authors agree to be accountable for all aspects of the work.

Acknowledgements

The authors gratefully acknowledge Mariam Elattar for the writing assistance utilized in the production of this manuscript and Neveen Kandil for her efforts in organizing the Delphi panel.

Reviewer disclosures

Peer reviewers on this manuscript have received an honorarium from JME for their review work but have no other relevant financial relationships to disclose.

Supplement statement

This article is part of a supplement sponsored by AstraZeneca. All articles within this supplement have been rigorously peer reviewed by experts in the field, as per Journal of Medical Economic’s peer review policy. Any conflicts of interest are stated in the “Declaration of financial/other relationships” section.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.