Skip to main content

Advertisement

SpringerLink
Log in

Direct medical costs and their predictors in South Korean patients with systemic lupus erythematosus

  • Original Article - Health Services Research
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

We aimed to estimate the annual direct medical costs of South Korean systemic lupus erythematosus (SLE) patients, and their predictors. The 2010 annual direct medical costs of SLE patients in the Hanyang BAE Lupus cohort in South Korea were assessed. The information was taken directly from the hospital database and medical records, and included clinical characteristics, disease activity, organ damage, and healthcare utilization. Cost predictors were estimated with a multivariate linear regression model. A total of 749 SLE patients (92.7 % female, mean age 35.7 ± 11.3 years, mean disease duration 9.6 ± 4.9 years) were studied. Their mean annual direct medical costs amounted to USD 3305. The largest component of these costs was the cost of medication (USD 1269, 38.4 %), followed by those of diagnostic procedures and tests (USD 1177, 35.6 %). Regression analysis showed that adjusted mean SLE disease activity index score (p < 0.0001), systemic damage index (p < 0.0001), and renal (p = 0.0039) and hematologic (p = 0.0353) involvement were associated with increased direct medical costs, whereas longer disease duration was associated with lower direct medical costs. Greater disease activity and greater organ damage predict higher costs for South Korean SLE patients. Major organ involvement such as renal disorder and hematologic involvement also predicts higher costs, whereas longer duration of disease predicts lower costs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sutcliffe N, Clarke AE, Taylor R, Frost C, Isenberg DA (2001) Total costs and predictors of costs in patients with systemic lupus erythematosus. Rheumatology 40(1):37–47 (Oxford)

    Article  CAS  PubMed  Google Scholar 

  2. Clarke AE, Esdaile JM, Bloch DA, Lacaille D, Danoff DS, Fries JF (1993) A Canadian study of the total medical costs for patients with systemic lupus erythematosus and the predictors of costs. Arthritis Rheum 36(11):1548–1559

    Article  CAS  PubMed  Google Scholar 

  3. Clarke AE, Petri M, Manzi S, Isenberg DA, Gordon C, Senecal JL, Penrod J, Joseph L, St Pierre Y, Fortin PR, Sutcliffe N, Richard Goulet J, Choquette D, Grodzicky T, Esdaile JM (2004) The systemic lupus erythematosus Tri-nation Study: absence of a link between health resource use and health outcome. Rheumatology 43(8):1016–1024. doi:10.1093/rheumatology/keh229 (Oxford)

    Article  CAS  PubMed  Google Scholar 

  4. Panopalis P, Petri M, Manzi S, Isenberg DA, Gordon C, Senecal JL, Penrod JR, Joseph L, St Pierre Y, Pineau C, Fortin PR, Sutcliffe N, Goulet JR, Choquette D, Grodzicky T, Esdaile JM, Clarke AE (2007) The systemic lupus erythematosus Tri-Nation study: cumulative indirect costs. Arthritis Rheum 57(1):64–70. doi:10.1002/art.22470

    Article  PubMed  Google Scholar 

  5. Pelletier EM, Ogale S, Yu E, Brunetta P, Garg J (2009) Economic outcomes in patients diagnosed with systemic lupus erythematosus with versus without nephritis: results from an analysis of data from a US claims database. Clin Ther 31(11):2653–2664. doi:10.1016/j.clinthera.2009.11.032

    Article  PubMed  Google Scholar 

  6. Gironimi G, Clarke AE, Hamilton VH, Danoff DS, Bloch DA, Fries JF, Esdaile JM (1996) Why health care costs more in the US: comparing health care expenditures between systemic lupus erythematosus patients in Stanford and Montreal. Arthritis Rheum 39(6):979–987

    Article  CAS  PubMed  Google Scholar 

  7. Panopalis P, Yazdany J, Gillis JZ, Julian L, Trupin L, Hersh AO, Criswell LA, Katz P, Yelin E (2008) Health care costs and costs associated with changes in work productivity among persons with systemic lupus erythematosus. Arthritis Rheum 59(12):1788–1795. doi:10.1002/art.24063

    Article  PubMed Central  PubMed  Google Scholar 

  8. Clarke AE, Bloch DA, Danoff DS, Esdaile JM (1994) Decreasing costs and improving outcomes in systemic lupus erythematosus: using regression trees to develop health policy. J Rheumatol 21(12):2246–2253

    CAS  PubMed  Google Scholar 

  9. Lacaille D, Clarke AE, Bloch DA, Danoff D, Esdaile JM (1994) The impact of disease activity, treatment and disease severity on short-term costs of systemic lupus erythematosus. J Rheumatol 21(3):448–453

    CAS  PubMed  Google Scholar 

  10. Clarke AE, Petri MA, Manzi S, Isenberg DA, Gordon C, Senecal JL, St Pierre Y, Joseph L, Penrod J, Fortin PR, Sutcliffe N, Goulet JR, Choquette D, Grodzicky T, Danoff DS, Ho V, Esdaile JM (1999) An international perspective on the well being and health care costs for patients with systemic lupus erythematosus. Tri-Nation Study Group. J Rheumatol 26(7):1500–1511

    CAS  PubMed  Google Scholar 

  11. Zhu TY, Tam LS, Lee VW, Lee KK, Li EK (2009) The impact of flare on disease costs of patients with systemic lupus erythematosus. Arthritis Rheum 61(9):1159–1167. doi:10.1002/art.24725

    Article  PubMed  Google Scholar 

  12. Zhu TY, Tam LS, Lee VW, Lee KK, Li EK (2009) Systemic lupus erythematosus with neuropsychiatric manifestation incurs high disease costs: a cost-of-illness study in Hong Kong. Rheumatology 48(5):564–568. doi:10.1093/rheumatology/kep031 (Oxford)

    Article  PubMed  Google Scholar 

  13. Meacock R, Dale N, Harrison MJ (2013) The humanistic and economic burden of systemic lupus erythematosus : a systematic review. Pharmacoeconomics 31(1):49–61. doi:10.1007/s40273-012-0007-4

    Article  PubMed  Google Scholar 

  14. Joo YB, Bae S (2014) Assessment of clinical manifestations, disease activity and organ damage in 996 Korean patients with systemic lupus erythematosus: comparison with other Asian populations. Int J Rheum Dis. doi:10.1111/1756-185x.12462

    Google Scholar 

  15. Thumboo J, Uramoto K, O’Fallon WM, Fong KY, Boey ML, Feng PH, Thio ST, Gabriel SE, Chng HH, Howe HS, Koh ET, Koh WH, Leong KH, Leong KP (2001) A comparative study of the clinical manifestations of systemic lupus erythematosus in Caucasians in Rochester, Minnesota, and Chinese in Singapore, from 1980 to 1992. Arthritis Rheum 45(6):494–500

    Article  CAS  PubMed  Google Scholar 

  16. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, Schaller JG, Talal N, Winchester RJ (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25(11):1271–1277

    Article  CAS  PubMed  Google Scholar 

  17. Gladman DD, Ibanez D, Urowitz MB (2002) Systemic lupus erythematosus disease activity index 2000. J Rheumatol 29(2):288–291

    PubMed  Google Scholar 

  18. Ibanez D, Urowitz MB, Gladman DD (2003) Summarizing disease features over time: I. Adjusted mean SLEDAI derivation and application to an index of disease activity in lupus. J Rheumatol 30(9):1977–1982

    PubMed  Google Scholar 

  19. Gladman D, Ginzler E, Goldsmith C, Fortin P, Liang M, Urowitz M, Bacon P, Bombardieri S, Hanly J, Hay E, Isenberg D, Jones J, Kalunian K, Maddison P, Nived O, Petri M, Richter M, Sanchez-Guerrero J, Snaith M, Sturfelt G, Symmons D, Zoma A (1996) The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum 39(3):363–369

    Article  CAS  PubMed  Google Scholar 

  20. Doria A, Amoura Z, Cervera R, Khamastha MA, Schneider M, Richter J, Guillemin F, Kobelt G, Maurel F, Garofano A, Perna A, Murray M, Schmitt C, Boucot I (2014) Annual direct medical cost of active systemic lupus erythematosus in five European countries. Ann Rheum Dis 73(1):154–160. doi:10.1136/annrheumdis-2012-202443

    Article  PubMed  Google Scholar 

  21. Cho J, Chang S, Shin N, Choi B, Oh H, Yoon M, Lee E, Lee E, Lee T, Song Y (2014) Costs of illness and quality of life in patients with systemic lupus erythematosus in South Korea. Lupus 23(9):949–957. doi:10.1177/0961203314524849

    Article  CAS  PubMed  Google Scholar 

  22. Huscher D, Merkesdal S, Thiele K, Zeidler H, Schneider M, Zink A (2006) Cost of illness in rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and systemic lupus erythematosus in Germany. Ann Rheum Dis 65(9):1175–1183. doi:10.1136/ard.2005.046367

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Clarke AE, Panopalis P, Petri M, Manzi S, Isenberg DA, Gordon C, Senecal JL, Joseph L, St Pierre Y, Li T (2008) SLE patients with renal damage incur higher health care costs. Rheumatology 47(3):329–333. doi:10.1093/rheumatology/kem373 (Oxford)

    Article  CAS  PubMed  Google Scholar 

  24. Li T, Carls GS, Panopalis P, Wang S, Gibson TB, Goetzel RZ (2009) Long-term medical costs and resource utilization in systemic lupus erythematosus and lupus nephritis: a five-year analysis of a large medicaid population. Arthritis Rheum 61(6):755–763. doi:10.1002/art.24545

    Article  PubMed  Google Scholar 

  25. Liang MH, Corzillius M, Bae SC (1999) The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum 42(4):599–608. doi:10.1002/1529-0131(199904)42:4<599:aid-anr2>3.0.co;2-f

    Article  Google Scholar 

  26. Al Dhanhani AM, Gignac MA, Su J, Fortin PR (2009) Work disability in systemic lupus erythematosus. Arthritis Rheum 61(3):378–385. doi:10.1002/art.24347

    Article  PubMed  Google Scholar 

  27. McElhone K, Abbott J, Teh LS (2006) A review of health related quality of life in systemic lupus erythematosus. Lupus 15(10):633–643

    Article  CAS  PubMed  Google Scholar 

  28. Zhu TY, Tam LS, Li EK (2011) Cost-of-illness studies in systemic lupus erythematosus: a systematic review. Arthritis Care Res 63(5):751–760. doi:10.1002/acr.20410 (Hoboken)

    Article  Google Scholar 

Download references

Funding

This study was supported by a grant from GlaxoSmithKline, Korea and the Korea Healthcare Technology R&D project, Ministry for Health & Welfare, Republic of Korea (A120404).

Author contribution

All the authors made substantial contributions to the conception and design of the manuscript, data acquisition/analysis, interpretation, drafting, or critical revision of the manuscript and approved it for publication. They meet the recommend criteria for authorship of the International Committee of Medical Journal Editors for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals (ICMJE Recommendations 2013).

Author information

Author notes

    Authors and Affiliations

    1. Department of Rheumatology, Myongji Hospital, Goyang, Republic of Korea

      So-Yeon Park

    2. Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 17 Haengdang-Dong, Seongdong-Gu, Seoul, 133-792, Republic of Korea

      Young Bin Joo, Yoon-Kyoung Sung & Sang-Cheol Bae

    3. Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea

      Jeeseon Shim

    4. Clinical Research Center for Rheumatoid Arthritis (CRCRA), Seoul, Republic of Korea

      Yoon-Kyoung Sung & Sang-Cheol Bae

    Authors
    1. So-Yeon Park
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Young Bin Joo
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Jeeseon Shim
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Yoon-Kyoung Sung
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Sang-Cheol Bae
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Sang-Cheol Bae.

    Ethics declarations

    Conflicts of interest

    The authors declare that they have no conflict of interest.

    Additional information

    S.-Y. Park and Y. B. Joo have contributed equally to this work.

    Electronic supplementary material

    Below is the link to the electronic supplementary material.

    Supplementary material 1 (DOCX 24 kb)

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Park, SY., Joo, Y.B., Shim, J. et al. Direct medical costs and their predictors in South Korean patients with systemic lupus erythematosus. Rheumatol Int 35, 1809–1815 (2015). https://doi.org/10.1007/s00296-015-3344-8

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s00296-015-3344-8

    Keywords

    Search

    Navigation