Objectives: To examine the real-world healthcare resource utilization (HCRU) and costs of patients with systemic lupus erythematosus (SLE) in Taiwan.

Methods: Taiwan’s National Health Insurance Research Database (NHIRD) from 1/1/2014 to 12/31/2019 was utilized. Patients holding catastrophic illness certificates for SLE in 2015-2017 were identified. Enrolled patients aged ≥ 18 years were then divided into three groups (mild, moderate, and severe) based on the highest severity patients experienced in one year following the enrollment date using a published claims-based algorithm that incorporates SLEDAI, SLAM, BILAG and expert clinical opinion, and indexed upon the first date of entering the severity group. HCRU and costs were measured at index and during the two-year follow-up period after the index date.

Results: There were 20,181 patients with catastrophic illness certificates for SLE included in this study with the average prevalence of 97.0 and the average incidence of 4.0 per 100,000 in 2015-2017. Of these patients, 29.3% (n=5,918) were mild SLE, 60.7%(n=12,253) were moderate SLE and 10.0% (n=2,010) were severe SLE. During the first year of follow up, 50.1% of severe patients had hospitalization with 2.8 admissions and 25.2 length of stays, while 24.0% for moderate patients with 2.2 admissions and 19.6 days, and 11.0% for mild patients with 1.7 admission and 17.5 days. Severe patients had mean total costs of NT$168,151 in year one compared with NT$109,200 for moderate patients, and NT$77,089 for mild patients. Outpatient costs constituted a significant proportion of total costs (severe: 58%; moderate: 74%; mild: 85%). Medication costs were 23%, 30%, 30% of total costs for mild, moderate, and severe patients, respectively.

Conclusions: SLE has substantial impact on HCRU and costs in Taiwan, especially for those with higher disease severity. Effective treatment for SLE patients may offer significant savings in HCRU and costs.