Description and Healthcare Resource Utilization of Patients With Moderate or Severe Lupus Using US Insurance Claims

Author(s)

Patrick Ward, PhD1, Andrew Heaney, PhD1, Bennett THOMSON, PhD1, PADRAIG KEARNEY, PhD1, CORINE GAILLEZ, MD2, Manik Kalra, PhD3, Julie Le Moal Mouchet, PhD4;
1NOVARTIS, DUBLIN, Ireland, 2NOVARTIS, BASEL, Switzerland, 3NOVARTIS, LONDON, United Kingdom, 4Novartis A.G., BASEL, Switzerland

Presentation Documents

OBJECTIVES: Identify patients with moderate or severe lupus in US insurance claims and describe their demographic and clinical characteristics as well as their healthcare resource utilization (HCRU).
METHODS: An algorithm was built by combining diagnostic codes (International Classification of Diseases ICD-10 M32.1x, M32.8 and M32.9 for SLE), treatment episodes and rheumatologist visits. Lupus severity was determined based on the exposure to specific drugs and clinical events indicative of organ damage associated with moderate and severe stages. Study period was 01Jan2015 - 31Mar2023. Index date was defined as the start date when the moderate or severe stage was reached. Demographic and clinical characteristics of the study population were reported, as well as their HCRU.
RESULTS: A total of 3,202 and 3,930 patients with severe and moderate lupus, were respectively, identified. Severe patients were slightly older than moderate patients with a mean age of 60.6 (SD:16.0) and 55.2 (SD:15.4) years, respectively. African American (AA), Hispanic and Asian races were quite prevalent in both cohorts: severe (21.0%, 12.5% and 3.4%) and moderate (16.1%, 14.8% and 4.0%). Post-index organ damage increased with severity​ (severe: 61.6%​ vs. moderate: 55.6%) and the trend was even more marked for renal involvement (severe: 18.2% ​vs. moderate: 7.6%). More Asians, AA and Hispanics have organ involvement (including renal) compared to Caucasians, regardless of their disease severity. Depression was reported for 25.0% and 35.5% of moderate and severe patients, respectively. Use of biologics increased with lupus severity, but reached only 17% for the severe population. About 90% of patients have visited their GP or internal medicine doctor within 2 years after index. Inpatient, emergency room and nephrology visits clearly increased with lupus severity.
CONCLUSIONS: Patients with moderate or severe lupus have distinct demographic and clinical characteristics, showed a low use of biologics and a high HRCU, highlighting the need for better treatment options.

Conference/Value in Health Info

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

Value in Health, Volume 28, Issue S1

Code

EE475

Topic

Economic Evaluation

Disease

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

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