ORGAN DAMAGE IN SYSTEMIC LUPUS ERYTHEMATOSUS AND IMPACT ON HCRU & COST: AN OBSERVATIONAL STUDY OF PATIENTS IN THE NATIONAL FRENCH INSURANCE CLAIMS DATABASE (SNDS)
Author(s)
LAUREN INCHBOARD, MSc1, Marine Vierling, MSc1, Annaelle David, PharmD1, Zahir Amoura, MD, MSc2, François Chasset, MD, PhD2, Gabriel Choukroun, MD, PhD3, Alexandre Teboul, MD2, Christophe Richez, MD, PhD4, Sophie LARRIEU, PhD1, Patricia Pujol, PharmD, PhD5, Bénédicte SABIN, PharmD, MSc5.
1HORIANA, Bordeaux, France, 2APHP, Paris, France, 3CHU Amiens, Amiens, France, 4CHU Bordeaux, Bordeaux, France, 5GSK France, Rueil Malmaison, France.
1HORIANA, Bordeaux, France, 2APHP, Paris, France, 3CHU Amiens, Amiens, France, 4CHU Bordeaux, Bordeaux, France, 5GSK France, Rueil Malmaison, France.
OBJECTIVES: Within 10 years of diagnosis, over half of patients with Systemic Lupus Erythematosus (SLE) develop organ damage (OD) leading to increased morbidity, mortality and healthcare cost burden. The EPILOG study aimed to quantify the burden of OD in SLE patients in the SNDS.
METHODS: SLE patients were identified using ICD-10 codes M32-1, M32-8 or M32-9 recorded as hospital diagnosis or long-term disease (LTD), with a confirmatory indicator of SLE and no alternative diagnosis, over 2013-2023. Index date was the earliest of either SLE treatment initiation, lupus nephritis diagnosis or first ICD-10 code. OD across 12 organ systems were identified from 6 months before index date to end of follow-up, using claims algorithms derived from the SLICC/ACR Damage Index (SDI). Annual healthcare costs and hospitalization duration were compared in patients with or without OD.
RESULTS: Among 26,888 patients (median follow-up 6.3 years), OD occurred in 29.8% of adults (N=25,470) and 18.9% of children (N=1,418). Annual mean healthcare costs were higher with OD: €19,420 vs €7,269 in children and €15,351 vs €5,640 in adults. The main driver was inpatient care (€8,404 vs €1,844 outpatient, adults), and medications drove outpatient differences (€2,122 vs €986). Annual median hospitalization duration was greater with OD (children: 10.1 vs 2.8 days; adults: 6.2 vs 0.9). For OD occurring >6 months after index date, costs increased by factors of 1.53 in children and up to 2.09 in adults aged 51-65 years. Adults without comorbidities had lower burden but larger increases in costs (2.33 vs 1.68 factor) and hospitalizations (2.88 vs 2.07) after OD.
CONCLUSIONS: This study shows how OD substantially increases the clinical and economic burden of SLE, despite the inherent limitations of identifying OD in the SNDS administrative database. These findings highlight the importance of optimized disease management strategies aimed at preventing OD and improving long-term outcomes. Funding: GSK (223404)
METHODS: SLE patients were identified using ICD-10 codes M32-1, M32-8 or M32-9 recorded as hospital diagnosis or long-term disease (LTD), with a confirmatory indicator of SLE and no alternative diagnosis, over 2013-2023. Index date was the earliest of either SLE treatment initiation, lupus nephritis diagnosis or first ICD-10 code. OD across 12 organ systems were identified from 6 months before index date to end of follow-up, using claims algorithms derived from the SLICC/ACR Damage Index (SDI). Annual healthcare costs and hospitalization duration were compared in patients with or without OD.
RESULTS: Among 26,888 patients (median follow-up 6.3 years), OD occurred in 29.8% of adults (N=25,470) and 18.9% of children (N=1,418). Annual mean healthcare costs were higher with OD: €19,420 vs €7,269 in children and €15,351 vs €5,640 in adults. The main driver was inpatient care (€8,404 vs €1,844 outpatient, adults), and medications drove outpatient differences (€2,122 vs €986). Annual median hospitalization duration was greater with OD (children: 10.1 vs 2.8 days; adults: 6.2 vs 0.9). For OD occurring >6 months after index date, costs increased by factors of 1.53 in children and up to 2.09 in adults aged 51-65 years. Adults without comorbidities had lower burden but larger increases in costs (2.33 vs 1.68 factor) and hospitalizations (2.88 vs 2.07) after OD.
CONCLUSIONS: This study shows how OD substantially increases the clinical and economic burden of SLE, despite the inherent limitations of identifying OD in the SNDS administrative database. These findings highlight the importance of optimized disease management strategies aimed at preventing OD and improving long-term outcomes. Funding: GSK (223404)
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
SA77
Topic
Economic Evaluation, Epidemiology & Public Health, Study Approaches
Disease
Rare & Orphan Diseases