title: A Retrospective Administrative Claims Database Evaluation of the Utilization of Belimumab in US Managed Care Settings.
abstract: OBJECTIVE
  Belimumab is an approved therapy for the treatment of systemic lupus erythematosus (SLE). This study examined the real-world utilization patterns of belimumab and standard SLE therapies in patients after regulatory approval of belimumab in the United States.
  
  
  METHODS
  A retrospective, observational study of belimumab users in the HealthCore Integrated Research Database was conducted using administrative claims data (GlaxoSmithKline Clinical Study Register Study ID: 114955). The overall population for analysis was composed of patients who were prescribed belimumab, had ≥6 months pre- and ≥6 months post-index medical and pharmacy eligibility, and at least 1 medical claim for SLE. Patients' clinical and demographic characteristics, treatment history, treatment patterns of belimumab, utilization of other medications, all-cause resource utilization, and costs were assessed. No hypotheses were tested.
  
  
  RESULTS
  All patients who were prescribed belimumab had an SLE claim. Patients who met all eligibility criteria (n = 155) were primarily female (94.2%; mean [SD] age, 44 [12] years) and 94.2% had used standard SLE therapies during the pre- and post-index periods. The majority had moderate SLE disease severity pre-index, and there was a small shift (approximately 8%) from moderate to mild SLE after initiation of belimumab. Two thirds of patients remained on belimumab therapy at 6 months post-index. The percentage of patients with any claim for oral corticosteroids remained stable; however, the point estimate for mean daily dose decreased slightly in months 3 to 6 post-index. Inpatient hospital admissions decreased slightly in the post-index period. The point estimate for total costs (excluding belimumab) decreased after initiation of belimumab, although overall total health care costs (including belimumab) increased.
  
  
  CONCLUSIONS
  All patients with a belimumab prescription had an SLE diagnosis on at least 1 medical claim, and the vast majority of those meeting all eligibility criteria had previously used a standard SLE therapy. Disease severity improved for a number of patients while on belimumab treatment and modest corticosteroid dose reductions were observed in later months. After initiating belimumab, health care costs (excluding belimumab) decreased. GlaxoSmithKline Clinical Study Register Study ID: 114955.
authors.affiliation: HealthCore Inc. Wilmington, Delaware. Electronic address: xke@healthcore.com.
authors.forename: Xuehua
authors.initials: X
authors.lastname: Ke
authors.affiliation: HealthCore Inc. Wilmington, Delaware.
authors.forename: Debra F
authors.initials: DF
authors.lastname: Eisenberg Lawrence
authors.affiliation: GlaxoSmithKline, Research Triangle Park, North Carolina.
authors.forename: Alan
authors.initials: A
authors.lastname: Oglesby
authors.affiliation: GlaxoSmithKline, Research Triangle Park, North Carolina.
authors.forename: Jeetvan
authors.initials: J
authors.lastname: Patel
authors.affiliation: GlaxoSmithKline, Research Triangle Park, North Carolina.
authors.forename: Hong
authors.initials: H
authors.lastname: Kan
authors.affiliation: GlaxoSmithKline, Research Triangle Park, North Carolina.
authors.forename: Robert
authors.initials: R
authors.lastname: Boggs
mesh_terms: D000067575:Administrative Claims, Healthcare / Q000706:statistics & numerical data*; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000191:economics / Q000627:therapeutic use; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C511911:belimumab
keywords: belimumab; real world; systemic lupus erythematosus; utilization patterns