ECONOMIC BURDEN BEFORE AND AFTER SJOGREN'S DISEASE DIAGNOSIS IN THE US: A RETROSPECTIVE CLAIMS-BASED ANALYSIS
Author(s)
Amie Devlin, PhD1, William Reiss, Pharm.D.1, Sol Han, MPH2, Navya Koneripalli, MPH2, Parisa Asad, PhD1.
1argenx, Ghent, Belgium, 2ZS Associates, Evanston, IL, USA.
1argenx, Ghent, Belgium, 2ZS Associates, Evanston, IL, USA.
OBJECTIVES: Sjögren’s disease (SjD) is a chronic, systemic autoimmune disease characterized by exocrine gland dysfunction and heterogeneous extra-glandular manifestations that often require multidisciplinary clinical management. In addition to symptom burden, the multisystem nature of SjD may lead to increased healthcare resource use. Understanding pre- and post-diagnosis cost patterns is important to characterize the economic impact of SjD, identify key cost drivers, and inform healthcare planning, and value assessments.
METHODS: This retrospective cohort study used electronic health records and claims data from Optum's de-identified Market Clarity Data (Optum® Market Clarity; January 2017-March 2020). Adults with newly-diagnosed SjD (including those with other systemic autoimmune disease) were identified using ≥2 SjD claims (ICD-10-CM M35.0x; 30-365 days apart), with no SjD claims during the 12-month baseline period. Claims within ±7 days of a SjD diagnosis were considered in determining costs. Healthcare costs (medical/pharmacy) during the 12-month baseline and follow-up periods were described using means, medians, standard deviations (SDs), and interquartile ranges (IQRs).
RESULTS: A total of 12,651 patients (mean age: 57 years [SD: 14]; 90% female) were identified. Mean total annual healthcare costs increased from $5,672 (SD: $23,562) during baseline to $11,129 (SD: $31,051) during follow-up. Median costs showed a similar increase from $223 (IQR: $0-$1,592) at baseline to $2,153 [IQR: $897-$7,577] after diagnosis. Outpatient costs accounted for the largest share of costs in both periods ($1,882 [SD: $9,665] to $5,279 [SD: $12,429]). Increases were also seen for drug administration ($344 [SD: $7,009] to $881 [SD: $6,700]) and ancillary/diagnostic services ($455 [SD: $2,450] to $1,225 [SD: $3,910]). Mean inpatient costs also increased from $3,564 (SD: $20,205) during baseline to $5,154 (SD: $24,392) during follow-up.
CONCLUSIONS: Among adults with SjD, healthcare costs were higher in the 12 months following diagnosis than in the 12 months before diagnosis, with outpatient and inpatient costs contributing substantially to total costs.
METHODS: This retrospective cohort study used electronic health records and claims data from Optum's de-identified Market Clarity Data (Optum® Market Clarity; January 2017-March 2020). Adults with newly-diagnosed SjD (including those with other systemic autoimmune disease) were identified using ≥2 SjD claims (ICD-10-CM M35.0x; 30-365 days apart), with no SjD claims during the 12-month baseline period. Claims within ±7 days of a SjD diagnosis were considered in determining costs. Healthcare costs (medical/pharmacy) during the 12-month baseline and follow-up periods were described using means, medians, standard deviations (SDs), and interquartile ranges (IQRs).
RESULTS: A total of 12,651 patients (mean age: 57 years [SD: 14]; 90% female) were identified. Mean total annual healthcare costs increased from $5,672 (SD: $23,562) during baseline to $11,129 (SD: $31,051) during follow-up. Median costs showed a similar increase from $223 (IQR: $0-$1,592) at baseline to $2,153 [IQR: $897-$7,577] after diagnosis. Outpatient costs accounted for the largest share of costs in both periods ($1,882 [SD: $9,665] to $5,279 [SD: $12,429]). Increases were also seen for drug administration ($344 [SD: $7,009] to $881 [SD: $6,700]) and ancillary/diagnostic services ($455 [SD: $2,450] to $1,225 [SD: $3,910]). Mean inpatient costs also increased from $3,564 (SD: $20,205) during baseline to $5,154 (SD: $24,392) during follow-up.
CONCLUSIONS: Among adults with SjD, healthcare costs were higher in the 12 months following diagnosis than in the 12 months before diagnosis, with outpatient and inpatient costs contributing substantially to total costs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE272
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)