Estimating the U.S. Economic Burden of Autoimmune Diseases: A Pilot Systematic Literature Review

Author(s)

Lu Shi, PhD1, Pei-Jung Lin, PhD1, Sarah Mullin, BS1, Xiaoyan Wang, MS1, Joshua Cohen, PhD1, Glenn Phillips, PhD2.
1Center for the Evaluation of Value and Risk in Health at Tufts Medical Center, Boston, MA, USA, 2Argenx, Gent, Belgium.
OBJECTIVES: Autoimmune diseases include multiple distinct conditions, affecting 5-8% of the U.S. population. However, cost estimates are not available for all conditions. This pilot systematic literature review characterized cross-study differences that pose a challenge to assessing the aggregate economic burden in the U.S. across all autoimmune diseases.
METHODS: The review selected illustrative diseases from an initial list of 161 recognized autoimmune conditions from the Global Autoimmune Institute’s disease catalog. Our systematic review identified cost literature from PubMed searches for US-based, English-language studies published from 2000 to 2024. We summarized direct costs (e.g. related to medical expenditures), indirect costs (e.g. productivity losses), and total costs. We estimated population annual costs by scaling individual costs by prevalence. Finally, we compared methodologies across studies, focusing on differences that might pose challenges to literature synthesis.
RESULTS: Our pilot assessment reviewed cost literature for 12 diseases: acromegaly, alopecia areata, bullous pemphigoid, chagas disease, chronic autoimmune urticaria, Crohn’s disease, eczema, endometriosis, granulomatosis with polyangiitis (GPA), Henoch-Schönlein purpura, juvenile polymyositis, and lupus nephritis. We found pertinent literature for eight diseases and none for four: bullous pemphigoid, chagas disease, Henoch-Schönlein purpura, and juvenile polymyositis. Annual U.S. disease-related cost estimates ranged from $18 million to $9 billion. Notable methodological differences complicating literature synthesis included differences in (1) how studies defined the diseased population, (2) data sources (e.g., claims vs. survey data; or cost vs. charge data), and (3) types of costs included (e.g., procedure costs only vs. procedure costs plus drugs).
CONCLUSIONS: Methodological heterogeneity across studies poses a substantial challenge to the synthesis of information for estimating the aggregate cost of autoimmune disease in the U.S. We encourage characterization of uncertainty attending synthesis efforts and harmonization of methods to overcome these challenges.

Conference/Value in Health Info

2025-05, ISPOR 2025, Montréal, Quebec, CA

Value in Health, Volume 28, Issue S1

Code

EE381

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs

Disease

SDC: Rare & Orphan Diseases, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)

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