ECONOMIC AND SOCIETAL BURDEN OF LUPUS NEPHRITIS IN LATIN AMERICA (LATAM): A MULTICOUNTRY ANALYSIS INCLUDING DIRECT MEDICAL COSTS AND PRODUCTIVITY LOSSES
Author(s)
Juan Mejía-Vilet, MD1, Guillermo Pons-Estel, MD2, Ricardo M Xavier, MD3, Jorge Pérez-Velásquez, MD4, María Jose Villar, MD5, Dina Arrieta, MD6, Louis Roberto Muñoz, MD7, Edgardo González-Sevillano, MD8, Mijahil Pavel Cornejo-Ortega, MD9, Martín Rebella, MD10, Isabel Acosta, MD11, Claudia Vera-Barrezueta, MD12, Liudmila Valentina Maldonado-Romero, MD13, Melissa Diaz Puentes, MSc, MD14, Claudia Hernández-Castillo, R.N, MSc14, Sergio Cáceres-Maldonado, MD, MSc14, Juan Ignacio Altuna, BEc15, Veronica Elizabeth Mata, MBA, MSc, PhD16, Nelson Correa, Sr., PhD16, Alegna Rada, PhD17, Allan Rimola, Sr., MD18, Daniel Hector Espinoza-Herrera, MD, Msc19, Anthony Delgado, MD20, Mariana Osorio, BSc21, Paula Soledad Luque, Sr., MD22, Andrea Barquet, MD23, Mauricio Hernandez, MD, MSc14.
1Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico, 2Centro Regional de Enfermedades Autoinmunes y Reumáticas, Rosario, Argentina, 3Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil, 4Clínica de la Costa, Barranquilla, Colombia, 5Clínica Alemana, Santiago de Chile, Chile, 6Hospital Clínica Bíblica San José, San José, Costa Rica, 7Hospital Docente Padre Billini, Santo Domingo, Dominican Republic, 8Consultorios América, Ciudad de Panamá, Panama, 9Servicio de Inmuno reumatología del Hospital Nacional Arzobispo Loayza, Sociedad Peruana de Reumatología, Lima, Peru, 10Facultad de Medicina, Unidad de Enfermedades Autoinmunes Sistémicas, Hospital de Clínicas, UDELAR, Monte Video, Uruguay, 11Departamento de Reumatología, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Asunción, Paraguay, 12Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador, 13Hospital Teodoro Maldonado Carbo, Guayaquil, Ecuador, 14Roche, Bogotá, Colombia, 15Roche, Buenos Aires, Argentina, 16Roche, São Paulo, Brazil, 17Roche, Santiago, Chile, 18Roche, San José, Costa Rica, 19Roche, Lima, Peru, 20Roche, Guayaquil, Ecuador, 21Roche, México DF, Mexico, 22Roche, José León Suarez, Argentina, 23Roche, Montevideo, Uruguay.
1Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico, 2Centro Regional de Enfermedades Autoinmunes y Reumáticas, Rosario, Argentina, 3Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil, 4Clínica de la Costa, Barranquilla, Colombia, 5Clínica Alemana, Santiago de Chile, Chile, 6Hospital Clínica Bíblica San José, San José, Costa Rica, 7Hospital Docente Padre Billini, Santo Domingo, Dominican Republic, 8Consultorios América, Ciudad de Panamá, Panama, 9Servicio de Inmuno reumatología del Hospital Nacional Arzobispo Loayza, Sociedad Peruana de Reumatología, Lima, Peru, 10Facultad de Medicina, Unidad de Enfermedades Autoinmunes Sistémicas, Hospital de Clínicas, UDELAR, Monte Video, Uruguay, 11Departamento de Reumatología, Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Asunción, Paraguay, 12Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador, 13Hospital Teodoro Maldonado Carbo, Guayaquil, Ecuador, 14Roche, Bogotá, Colombia, 15Roche, Buenos Aires, Argentina, 16Roche, São Paulo, Brazil, 17Roche, Santiago, Chile, 18Roche, San José, Costa Rica, 19Roche, Lima, Peru, 20Roche, Guayaquil, Ecuador, 21Roche, México DF, Mexico, 22Roche, José León Suarez, Argentina, 23Roche, Montevideo, Uruguay.
OBJECTIVES: Lupus nephritis (LN) causes progressive kidney damage and significant healthcare resource use (HCRU), frequently affecting young, working-age populations. This study aimed to estimate the economic and societal burden of LN across 12 LATAM countries for 2024, including direct medical costs, productivity losses and informal care across disease stages.
METHODS: Median annual per-patient costs and the total economic burden of LN were estimated across chronic kidney disease (CKD) stages 1-4, dialysis and first year after kidney transplant, adopting a societal perspective. Clinical experts validated HCRU inputs (medical consultations, laboratory tests, imaging, procedures, hospitalizations, and pharmacological treatments). Unit costs were sourced from country-specific public databases and literature and expressed in 2024 USD. Productivity losses (employment participation and work productivity-WP-) were estimated using the human capital approach.
RESULTS: Regional median annual per-patient direct medical costs were USD13,385 for CKD stages 1-4, USD38,356 for dialysis, and USD47,695 for transplant, representing a total burden exceeding USD3 billion across an estimated 172,000 prevalent cases of LN. Median cost drivers by stage were: specific disease treatment (43%) in CKD1-4; for dialysis therapy (59%) and concomitant medications (22%) in dialysis; immunosuppressant therapy (50%) and transplant procedure (42%) in transplant. Across CKD stages 1-3, 4, dialysis, and transplant, respectively, median employment rates were 68%, 27%, 11%, and 59%; median annual WP loss reached 18, 28, 148, and 29 days; and informal care was required in 50%, 65%, 90%, and 45%.
CONCLUSIONS: LN imposes a substantial economic and societal burden across LATAM, driven by disease progression and productivity losses in working-age populations. Compared to stages 1-4, dialysis and transplant are 2- and 3-times more costly. These findings highlight the value of strategies that delay CKD progression, improve disease control and preserve work participation and productivity, providing key regional data to support decision-making, resource allocation, and access strategies.
METHODS: Median annual per-patient costs and the total economic burden of LN were estimated across chronic kidney disease (CKD) stages 1-4, dialysis and first year after kidney transplant, adopting a societal perspective. Clinical experts validated HCRU inputs (medical consultations, laboratory tests, imaging, procedures, hospitalizations, and pharmacological treatments). Unit costs were sourced from country-specific public databases and literature and expressed in 2024 USD. Productivity losses (employment participation and work productivity-WP-) were estimated using the human capital approach.
RESULTS: Regional median annual per-patient direct medical costs were USD13,385 for CKD stages 1-4, USD38,356 for dialysis, and USD47,695 for transplant, representing a total burden exceeding USD3 billion across an estimated 172,000 prevalent cases of LN. Median cost drivers by stage were: specific disease treatment (43%) in CKD1-4; for dialysis therapy (59%) and concomitant medications (22%) in dialysis; immunosuppressant therapy (50%) and transplant procedure (42%) in transplant. Across CKD stages 1-3, 4, dialysis, and transplant, respectively, median employment rates were 68%, 27%, 11%, and 59%; median annual WP loss reached 18, 28, 148, and 29 days; and informal care was required in 50%, 65%, 90%, and 45%.
CONCLUSIONS: LN imposes a substantial economic and societal burden across LATAM, driven by disease progression and productivity losses in working-age populations. Compared to stages 1-4, dialysis and transplant are 2- and 3-times more costly. These findings highlight the value of strategies that delay CKD progression, improve disease control and preserve work participation and productivity, providing key regional data to support decision-making, resource allocation, and access strategies.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE585
Topic
Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs
Disease
Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain), Urinary/Kidney Disorders