Presentation (CTI)

OBJECTIVES: Health economic evaluations have traditionally focused on direct healthcare costs and patient health outcomes, but decision-makers increasingly recognize broader elements of value, as articulated in the ISPOR value flower. Systemic lupus erythematosus (SLE) is a severe, multisystem, chronic disease with substantial patient, caregiver, and societal burden, suggesting potential relevance of wider value domains. This study assessed the extent to which published economic evaluations in SLE have incorporated value elements beyond costs and QALYs.
METHODS: Building on published review of decision analytic economic evaluations in SLE from 2020, the literature search was updated to 6th January 2026. Eligible studies were identified and reviewed and reported value elements were systematically extracted and mapped against the 12 domains of the ISPOR value flower.
RESULTS: The original review by Gavan et al. identified 2,330 papers, of which six were included. The updated search identified 769 additional records, yielding 17 further studies, and resulting in a total of 23 economic evaluations. All studies included net [direct] costs, such as treatment, event, hospitalization, dialysis, surgery and adverse event costs. Thirteen studies included patient QALYs, 12 incorporated a societal perspective including patient productivity costs. None included any other novel domain of value; one reported direct non-medical costs including transportation, accommodation and social services.
CONCLUSIONS: Despite the severity and complexity of SLE and potential for treatment value to extend beyond direct patient costs and QALYs, few economic appraisals have attempted to include these. Further research is needed to evaluate these elements in relation to SLE and assess how additional value domains may be incorporated into economic analysis.