title: [Cost of systemic lupus erythematosus for adult patients with active and treated disease in France (LUCIE study)].
abstract: OBJECTIVE
  To evaluate in France the annual direct medical cost of adult patients with active systemic lupus erythematosus (SLE) on medication and estimate the cost of a flare.
  
  
  METHODS
  A two-year, observational, retrospective, multicenter study, carried out between December 2010 and February 2011. Patients' characteristics, SLE disease activity and severity, rate of flares, healthcare consumption (medications, hospitalisations, etc.) were evaluated. Medical costs were assessed from the national Health Insurance perspective. Cost predictors were estimated using multivariate regression models.
  
  
  RESULTS
  Eight centres specialized in SLE management included 93 eligible patients (including 50.5% severe). The mean age was 39.9 (11.9) years and 93.5% were women. At baseline, the mean SLE duration was 9.8 (6.6) years. The mean scores of the SELENA-SLEDAI instrument and the SLICC/ACR index were higher in severe patients (9.8 vs 5.6, and 1.2 vs 0.4 respectively; P<0.001). Over the study period, 51% of patients received the combination containing at least corticosteroids or immunosuppressants. The mean annual direct medical cost of severe patients was €4660 versus €3560 for non-severe patients (non-significant difference). The cost of medications (61.8% of the annual cost) was higher in severe patients (€3214 vs €1856; P<0.05). Immunosuppressants and biologics represented 26.5% and 4.6% of the annual total cost respectively. Patients experienced on average 1.10 (0.59) flares/year, of which 0.50 were severe flare. The occurrence of a new severe flare incremented the annual cost of €1330 (P<0.05).
  
  
  CONCLUSIONS
  Medications represented the major component of the annual direct medical cost. Severe flares increase significantly the cost of SLE care management.
authors.affiliation: Service de médecine interne 2, Centre national de référence lupus, hôpital La Pitié-Salpétrière, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France. Electronic address: zahir.amoura@psl.aphp.fr.
authors.forename: Z
authors.initials: Z
authors.lastname: Amoura
authors.affiliation: Service de médecine interne et rhumatologie, CHU de Fort-de-France, BP 63297261, Fort-de-France cedex, Martinique.
authors.forename: C
authors.initials: C
authors.lastname: Deligny
authors.affiliation: Service de médecine interne, hôpital Robert-Debré, rue du Général-Koenig, 51090 Reims, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Pennaforte
authors.affiliation: Service de médecine interne, hôpital Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors.forename: M
authors.initials: M
authors.lastname: Hamidou
authors.affiliation: Service de médecine interne, hôpital Pèllegrin, place Amélie-Rabat-léon, 33076 Bordeaux cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Blanco
authors.affiliation: Service de médecine interne, hôpital Huriez, 1, place de Verdun, 59037 Lille cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Hachulla
authors.affiliation: Service de néphrologie et immunologie clinique, hôpital Rangueil, 1, avenue du Professeur-Jean-Pouhlès TSA 50032, 31059 Toulouse cedex 9, France.
authors.forename: J
authors.initials: J
authors.lastname: Pourrat
authors.affiliation: Service de médecine interne, hôpital l'Archet, 151, route Saint-Antoine-Ginestière BP 79, 06202 Nice cedex 3, France.
authors.forename: V
authors.initials: V
authors.lastname: Queyrel
authors.affiliation: IMS Real-World Evidence Solutions, Health Economics & Outcomes Research, Tour Ariane, 5-7, place de la Pyramide, 92088 La Défense cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Garofano
authors.affiliation: IMS Real-World Evidence Solutions, Health Economics & Outcomes Research, Tour Ariane, 5-7, place de la Pyramide, 92088 La Défense cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Maurel
authors.affiliation: GlaxoSmithKline, 100, route de Versailles, 78163 Marly-le-Roi cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Levy-Bachelot
authors.affiliation: GlaxoSmithKline, 100, route de Versailles, 78163 Marly-le-Roi cedex, France.
authors.forename: I
authors.initials: I
authors.lastname: Boucot
mesh_terms: D000328:Adult; D001688:Biological Products / Q000191:economics / Q000627:therapeutic use; D005260:Female; D005602:France / Q000453:epidemiology; D005938:Glucocorticoids / Q000191:economics / Q000627:therapeutic use; D006296:Health Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D001688:Biological Products; D005938:Glucocorticoids; D007166:Immunosuppressive Agents
keywords: Consommation de soins; Cost of the disease; Coût de la maladie; Flares; Healthcare consumption; Lupus systémique; Poussées; Systemic lupus erythematosus; Traitements; Treatments