Presentation (CTI)

OBJECTIVES: To synthesize evidence on the direct and indirect economic burden of Systemic Lupus Erythematosus (SLE) among women in the United States.
METHODS: A PubMed search was conducted to identify U.S.-based studies reporting economic outcomes in female patients with SLE aged 15-65 years. Eligible studies included observational designs (prospective, retrospective, or cross-sectional), and their quality was assessed using the Newcastle-Ottawa Scale.
RESULTS: From 1,437 initial studies, 15 studies met inclusion criteria (prospective = 2, retrospective = 12, cross-sectional = 1), encompassing 141,801 women. Mean total costs rose from $29,270 to $41,426 over the 6-month before and after SLE diagnosis, driven largely by outpatient services ($6,124 to $18,587) and hospital-based outpatient care ($7,042 to $11,453). Pregnancy significantly increased healthcare spending in women with SLE, with annual costs ranging from $20,665 to $21,509 compared to $12,591 in their non-pregnant counterparts. The largest cost difference was attributed to inpatient care. Hospitalization incidence ranged from 0.24% to 23.7 %, with median stays of 3-4 days. Outpatient visits were consistently high (3.8-9.6 visits per patient-year) and escalated with disease severity. Flare burden strongly predicted resource use: patients experiencing ≥7 flares per year averaged 2.18 emergency-department visits, which was considerably more than those with fewer flares. Indirect-cost evidence was limited but suggested notable productivity losses.
CONCLUSIONS: SLE imposes a substantial, heterogeneous economic burden on U.S. women. Costs surge after diagnosis, intensify during pregnancy, and climb with disease activity and flare frequency. These findings highlight the need for targeted interventions and informed resource allocation to mitigate the financial impact on this high-risk population.