The economic burden of systemic lupus erythematosus in Taiwan

Abstract

Background

Our cost-of-illness (COI) model adopted both payer and societal perspectives over a time horizon of 5 years to measure the economic burden of systemic lupus erythematosus (SLE) in Taiwan.

Methodology

A prevalence-based model was established to estimate the economic consequences of SLE after diagnosis in Taiwan. The model included four health states: (i) the three phenotypes representing mild, moderate, and severe SLE, and (ii) death. The inputs were obtained from a literature review of all the clinical trials and validated using a Delphi panel. The Delphi panel’s insights included commonly used treatment strategies for patients with SLE within the Taiwanese healthcare system. The costs mentioned in this model are disease management, monitoring, transient event, and indirect costs. One-way sensitivity analyses were conducted to assess the model uncertainty.

Results

The number of patients with SLE in our COI model was 20,189. At diagnosis, the number of SLE patients with mild, moderate, and severe phenotypes was 5,916, 12,255, and 2019, respectively. The total SLE cost in Taiwan over 5 years from both payer and societal perspectives was estimated at TWD 3.9 and 47 billion, respectively. The costs per patient per year from the payer and societal perspective were TWD 38,775 ($2,758) and TWD 466,119 ($33,152), respectively.

Conclusion

The findings demonstrated that the burden of SLE in Taiwan over a time horizon of 5 years is substantially high, mainly due to the consequences of economic loss as it affects women and men during their working age, in addition to the costs of SLE management and its consequences, such as flares, infection, and organ damage. Therefore, more attention should be paid to limiting the progression of SLE and the occurrence of flares, and further economic evaluations are necessary to assess novel treatment strategies that could control the disease.

Keywords:

• Cost
• burden
• consequences
• systemic lupus erythematosus
• Taiwan

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: conducting the analysis, collecting data and writing manuscript. SH and DC: interpretation of data, and revision of manuscript. SH and DC: retrieving data, local clinical practice validation. All authors contributed to the article and approved the submitted version.

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 meetings.

Reviewer disclosures

The peer reviewers on this manuscript have received an honorarium from JME for their review work.

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 the Journal of Medical Economics peer review policy. Any conflicts of interest are stated in the “Declaration of financial/other relationships” section.