Effect of Socioeconomic Status on the Direct Costs of Lupus Nephritis in Colombian Patients
Author(s)
Prada SI1, Hormaza-Jaramillo AA2, Guzman T2, Vallecilla L2, Valencia A2, del Castillo D3, Mejía LM3, Fernández Ávila DG4, Mendez-Patarroyo P5, Aroca G6, Arredondo-González AM7, Preciado N8, Duarte-Rey C8
1Fundación Valle del Lili, Centro de Investigaciones Clínicas; Universidad Icesi, Centro PROESA, Cali, Colombia, 2Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Valle del Cauca, Colombia, 3Universidad del Valle, Hospital Universitario del Valle Evaristo García, Unidad de Investigación e Innovación, Cali, Valle del Cauca, Colombia, 4Hospital Universitario San Ignacio - Pontificia Universidad Javeriana, Bogotá, Colombia, 5Hospital Universitario Fundación Santafé de Bogotá, Centro de Estudios e Investigación en Salud; Universidad de los Andes, Facultad de Medicina, Bogotá, Colombia, 6Clínica de la Costa, Centro de Investigación Clínica de la Costa; Universidad Simón Bolívar, Barranquilla , ATL, Colombia, 7Sociedad de Cirugía de Bogotá, Hospital de San José, Centro de Investigaciones, Bogotá, Colombia, 8Medical Affairs, GSK, Bogotá, Colombia
Presentation Documents
OBJECTIVES: Lupus nephritis (LN) is one of the main complications of systemic lupus erythematosus (SLE) and imposes a significant economic burden. This study describes the direct cost of LN among patients treated at secondary and tertiary centers in Colombia and explores its association with socioeconomic status.
METHODS: This was a longitudinal, retrospective, and descriptive study. Patients aged ≥12 years and diagnosed with SLE and LN in 7 mid- and high-complexity centers in Colombia between January 1, 2015 and December 31, 2020 were included. Clinical and healthcare resource use data were extracted from medical records. Direct costs were calculated by multiplying observed resource use with unit prices from official listings. A post hoc generalized linear model with gamma distribution and log link function was fitted to compare the direct costs of disease between government-subsidized and employer-based contributory healthcare systems. Affiliation to government-subsidized healthcare system was considered a proxy of lower socioeconomic status.
RESULTS: The cohort included 280 patients (median age: 30 years; 88.6% female), with 155, 88, and 37 affiliated to the contributory, subsidized, or other healthcare systems, respectively. The final model included 231 patients with complete information on healthcare affiliation and all covariates. Patients affiliated to the subsidized system had an adjusted mean annual direct cost 54% higher than those in the contributory system after controlling for sex, age, hypertension, de novo LN, alcohol consumption, smoking, and baseline glomerular filtration rate ($12,251 ± 1,943 versus $7,979 ± 935 [2024 USD]; mean ratio: 1.54; 95% confidence interval: 1.03–2.29; p=0.036).
CONCLUSIONS: Resource utilization is disproportionately high for patients with SLE and LN affiliated to the subsidized healthcare system in Colombia, compared with patients in the contributory model. There is an opportunity to close the gap among different healthcare systems in Colombia and guarantee quality access to healthcare among patients.
Conference/Value in Health Info
Value in Health, Volume 27, Issue 12, S2 (December 2024)
Code
EE821
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)