Table 2.
Total direct medical costs by comparison type
| Author year, country (currency year, currency) | Period | Patients with LN, N | Comparison | Cost category | Cost results (USD) | p value |
|---|---|---|---|---|---|---|
| LN vs. no LN | ||||||
| Carls 2009 [29], USA (2005 USD) | 2000–2004 | 592 |
Patients with LN vs. Matched control patients without SLE |
Mean (SD) total medical expenditure in 12-month study period |
58,389 (99,483) vs 11,527 (21,935) |
< 0.001 |
| Li 2009 [38], USA (2006 USD) | 1999–2005 | 489 |
Patients with LN vs. Patients with SLE without LN Patients with LN without ESKD vs. Patients with ESKD |
Mean (median) annual medical costs per patient at year 5 Mean (median) annual medical costs per patient over time |
50,578 (21,500) vs. 16,638 (8496) |
NA |
| Year 1: | 18,002 (10,053) | |||||
| Year 2: | 15,953 (8706) | |||||
| Year 3: | 17,757 (9743) | |||||
| Year 4: | 30,899 (12,441) | |||||
| Year 5: | 38,434 (11,532) | |||||
| Year 1: | 47,660 (33,827) | |||||
| Year 2: | 43,614 (29,020) | |||||
| Year 3: | 58,357 (42,103) | |||||
| Year 4: | 83,232 (55,395) | |||||
| Year 5: | 106,982 (66,490) | |||||
| Pelletier 2009 [42], USA (2008 USD) | 2007 | 1068 |
Patients with LN vs. |
Total mean (SD) annual costs; SLE-related mean |
30,652 (51,749); 6991 (15,576) vs. |
N/A |
| Patients with SLE without LN | (SD) total annual costs | 12,029 (26,577); 2489 (11,194) | ||||
| Aghdassi 2011 [26], Canada (CAD)a | 2004–2009 | 79 |
Patients with LN vs. |
Mean (SD) total cost/4 weeks; Mean (SD) annual |
969 (765); 12,597 (9946) vs. |
|
| Patients with SLE without LN | cost | 814 (1011); 10,585 (13,149) | ||||
|
Patients with active LN vs. Patients with inactive LN |
1094 (790); 14,224 (10,265) vs. 703 (648); 9142 (8419) |
< 0.05 < 0.05 |
||||
| Furst 2013 [31], USA (2009 USD) | 2003–2008 | 907 |
Patients with LN vs. Matched patients without SLE |
Overall mean (95% CI) annual costs in 12-month post-index period |
33,472 (29,797–37,146) vs. 5347 (4719–5976) |
< 0.001 |
| Yeh 2013 [47], USA (USD) | 2004–2011 | 24,357 | Patients with differing numbers of renal diagnoses: | Annual medical costs | NA | |
|
≥ 1 renal diagnosis ≥ 2 renal diagnoses ≥ 3 renal diagnoses ≥ 3 renal diagnoses plus ≥ 3 nephrologist visits |
33,176 36,974 36,241 38,883 |
|||||
| Jönsen 2016 [34], Sweden (2011 USD) | 2003–2010 | 321 | Patients with LN |
Mean (SD) total direct cost; median (IQR) total |
14,190 (35,756); 4709 (1661–10,989) | NA |
| vs. | direct cost | vs. | ||||
| Patients with SLE without LN | 10,188 (28,352); 2860 (1153–7708) | |||||
| McCormick 2016 [39], Canada (2010 CAD) | 1996–2010 | 303/632 |
> 2 renal AND > 2 nephrologist visits LN vs. |
Unadjusted 5-year mean per-patient-year costs |
85,292 vs. |
< 0.01 |
|
Patients with SLE without LN > 2 renal OR > 2 nephrologist visits LN vs. |
33,022 70,538 vs. |
|||||
| Patients with SLE without LN | 27,487 | |||||
| Venegas 2017 [45], Philippines (2016 Philippine peso) | 2016 | 166 |
Patients with SLE requiring dialysis vs. |
Annual cost |
595,400 vs. |
< 0.001 |
|
Patients with LN without dialysis vs. Patients with SLE without LN |
144,700 vs. 55,020 |
|||||
| Tanaka 2018 [43], Japan (USD) | 2010–2012 | 110 |
Patients with NP lupus/LN vs. Patients with SLE without NP lupus/LN |
Mean (SD) total costs over the 3-year study period |
39,976 (47,563) vs. 22,500 (36,128) |
0.0004 |
| Worsening eGFR | ||||||
| Barber 2018 [27], Multipleb (2015 CAD) | 1999–2013 | 609 | Patients stratified by LN status and state of eGFR: |
Predicted annual health costs, mean (95% CI) |
NA | |
|
State 1 (LN) State 2 (LN) State 3 (LN) ESKD vs. |
3858 (2858–4859) 4012 (2362–5662) 20,837 (3628–38,046) 51,313 vs. |
|||||
|
State 1 (no LN) State 2/3 (no LN) |
1813 (1034–2593) 2955 (37–5873) |
|||||
| Barbour 2018 [28], Canada (2016 CA$) | 2000–2012 | 362 |
Patients with LN class III or IV (± V) disease vs. Patients with LN class V disease |
Annual per-patient cost |
209 (year 2000) vs. 1592 (year 2013) vs. |
< 0.001 |
| 118 (year 200) vs. 1002 (year 2013) | 0.016 | |||||
aDisease activity was determined using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K). SLEDAI > 6 was considered an active disease. bUSA, n = 426; Europe, n = 405; Canada, n = 372; Mexico, n = 184; and Korea, n = 158
CAD Canadian dollars, CI confidence interval, eGFR estimated glomerular filtration rate, ESKD end-stage kidney disease, IQR interquartile range, IV intravenous, LN lupus nephritis, NA not applicable, NP neuropsychiatric, SD standard deviation, SLE systemic lupus erythematosus, USA United States of America, USD US dollars