title: The cost of care of systemic lupus erythematosus (SLE) in the UK: annual direct costs for adult SLE patients with active autoantibody-positive disease.
abstract: OBJECTIVE
  The aim of the Systemic LUpus Erythematosus Cost of Care In Europe (LUCIE) study was to evaluate the annual direct medical costs of managing adults with active autoantibody-positive disease on medication for SLE in secondary care. This paper presents the UK analyses only.
  
  
  METHODS
  A cost-of-illness study was conducted from the perspective of the National Health Service. Health resource utilization data were retrieved over a two-year period from four centres in England and unit cost data were taken from published sources.
  
  
  RESULTS
  At baseline, 86 patients were included, 38 (44.2%) had severe SLE and 48 (55.8%) had non-severe SLE. The mean (SD) SELENA-SLEDAI score was 7.7 (5.7). The mean (SD) annual direct medical cost of was estimated at £3231 (£2333) per patient and was 2.2 times higher in patients with severe SLE compared with patients with non-severe SLE (p < 0.001). Multivariate model analyses showed that renal disease involvement (p = 0.0016) and severe flares (p = 0.0001) were associated with higher annual direct costs.
  
  
  CONCLUSIONS
  Improvement of the overall stability of SLE and early intervention to minimize the impact of renal disease may be two approaches to mitigate the long-term direct cost of managing SLE patients in the UK.
authors.affiliation: 1Lupus Research Unit, The Rayne Institute, St Thomas' Hospital, London, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Khamashta
authors.forename: I N
authors.initials: IN
authors.lastname: Bruce
authors.forename: C
authors.initials: C
authors.lastname: Gordon
authors.forename: D A
authors.initials: DA
authors.lastname: Isenberg
authors.forename: O
authors.initials: O
authors.lastname: Ateka-Barrutia
authors.forename: M
authors.initials: M
authors.lastname: Gayed
authors.forename: C
authors.initials: C
authors.lastname: Donatti
authors.forename: A-L
authors.initials: AL
authors.lastname: Guillermin
authors.forename: J
authors.initials: J
authors.lastname: Foo
authors.forename: A
authors.initials: A
authors.lastname: Perna
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003363:Cost Control; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D008181:Lupus Nephritis / Q000097:blood / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care / Q000191:economics*; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013222:State Medicine / Q000191:economics*; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D001323:Autoantibodies; D015415:Biomarkers
keywords: Lupus flare; antinuclear antibody; direct cost; health care resources; management costs