Table 2.
Healthcare resource use and costs
| Parameter | Value | References | ||
|---|---|---|---|---|
| Healthcare resource use and costs (2022 USD) | ||||
| Treatment costs | ||||
| Cost of Acthar Gel | $41,459 | Red Book 2022 [26] | ||
| Acthar Gel use (12 months) | 8.57 packs | Data on Filea | ||
| Medication utilization | ||||
| Proportion of patients | Acthar Gel | SoC | ||
| Corticosteroids | 58.0% | 100.0% | Myung 2017 [27] | |
| DMARDs | 37.0% | 50.0% | Myung 2017 [27] | |
| Biologics | 9.0% | 14.0% | Myung 2017 [27] | |
| Cost of medications | ||||
| Corticosteroids | $410 | AHRQ 2007 [28] | ||
| DMARDs | $2909 | AHRQ 2007 [28] | ||
| Biologics | $55,312 | Red Book 2022 [26] | ||
| Healthcare costs | Mild | Moderate | Severe | |
| Inpatient | $3444 | $5325 | $16,609 | Murimi-Worstell 2021 [9] |
| Outpatient | $11,589 | $13,669 | $27,208 | Murimi-Worstell 2021 [9] |
| ER | $399 | $825 | $1046 | Murimi-Worstell 2021 [9] |
| Physician office | $2314 | $3446 | $4346 | Murimi-Worstell 2021 [9] |
| Surgery | ||||
| Surgery rate | ||||
| Kidney Transplant | 2.4% | Lionaki 2014 [29] | ||
| Splenectomy | 3.1% | You 2004 [30] | ||
| Total hip or knee replacement | 33.2% | Mukherjee 2015 [58] | ||
| Surgery-related costs | ||||
| Kidney Transplant | $127,337 | Axelrod 2016 [31] | ||
| Splenectomy | $21,923 | Hamlat 2012 [32] | ||
| Total hip or knee replacement | $47,412 | Clair 2016 [33] | ||
| Organ damage | ||||
| Organ damage rate | ||||
| Cardiovascular | 30.1% | Pierotti 2015 [34] | ||
| Diabetes | 19.0% | Pierotti 2015 [34] | ||
| Gastrointestinal | 22.2% | Pierotti 2015 [34] | ||
| Malignancy | 36.3% | Pierotti 2015 [34] | ||
| Musculoskeletal | 64.5% | Pierotti 2015 [34] | ||
| Neuropsychiatric | 46.9% | Pierotti 2015 [34] | ||
| Ocular | 60.5% | Pierotti 2015 [34] | ||
| Peripheral vascular | 20.9% | Pierotti 2015 [34] | ||
| Pulmonary | 34.3% | Pierotti 2015 [34] | ||
| Renal | 26.0% | Pierotti 2015 [34] | ||
| Organ damage-related costs | ||||
| Cardiovascular | $2729 | Pierotti 2015 [34] | ||
| Diabetes | $5726 | Pierotti 2015 [34] | ||
| Gastrointestinal | $505 | Pierotti 2015 [34] | ||
| Malignancy | $1601 | Pierotti 2015 [34] | ||
| Musculoskeletal | $23,310 | Pierotti 2015 [34] | ||
| Neuropsychiatric | $8998 | Pierotti 2015 [34] | ||
| Ocular | $556 | Pierotti 2015 [34] | ||
| Peripheral vascular | $1860 | Pierotti 2015 [34] | ||
| Pulmonary | $51,775 | Pierotti 2015 [34] | ||
| Renal | $15,842 | Pierotti 2015 [34] | ||
| Pain-related costs | ||||
| Opioid use for pain | ||||
| Opioid use | 23.0% | Somers 2019 [35] | ||
| Cost of opioid use | $24,722 | Luo 2021 [36] | ||
| Substance use disorder | ||||
| SLE-related opioid abuse (> 1 year of opioid use) | 68.0% | Somers 2019 [35] | ||
| SLE patients on ≥ 2 opioids | 22.0% | Somers 2019 [35] | ||
| Opioid abuse and overdose | $24,503 | Luo 2021 [36] | ||
| Work Productivity Lossb | Acthar Gel | SoC | ||
| Absenteeism | 7.8% | 17.6% | Phase 4 SLE trial [21] | |
| Presenteeism | 27.3% | 51.8% | Phase 4 SLE trial [21] | |
| Activity impairment | 34.3% | 58.1% | Phase 4 SLE trial [21] | |
| SF-6D utility | ||||
| Response | 0.654 | Phase 4 SLE trial [21] | ||
| Non-response | 0.595 | Phase 4 SLE trial [21] | ||
| Disutilities | ||||
| Disutilities: patient outcomes | ||||
| Chronic OCS use | − 0.023 | ICER 2018 [40] | ||
| Exacerbation (new flare) | − 0.360 | Pollard 2015 [41] | ||
| Exacerbation Requiring Steroid Burst | − 0.100 | ICER 2018 [40] | ||
| Planning | − 0.106 | Pollard 2015 [41] | ||
| Body image | − 0.102 | Pollard 2015 [41] | ||
| Intimate relationships | − 0.020 | Pollard 2015 [41] | ||
| Burden to others | − 0.059 | Pollard 2015 [41] | ||
| Disutilities: surgery | ||||
| Kidney transplant | − 0.170 | Li 2017 [42] | ||
| Splenectomy | − 0.168 | Synder 2008 [43] | ||
| Total hip or knee replacement | − 0.261 | Benson 2016 [44] | ||
| Disutilities: organ damage | ||||
| Cardiovascular | − 0.076 | Di Tanna 2021 [45] | ||
| Diabetes (type 2) | − 0.110 | Matza 2007 [46] | ||
| Gastrointestinal | − 0.240 | Worbes-Cerezo 2019 [47] | ||
| Malignancy | − 0.110 | Choi 2015 [48] | ||
| Musculoskeletal | − 0.030 | Törmälehto 2018 [49] | ||
| Neuropsychiatric | − 0.640 | Pollard 2015 [41] | ||
| Ocular | − 0.029 | Brown 2009 [50] | ||
| Peripheral vascular | − 0.076 | Assumption [same as cardiovascular] | ||
| Pulmonary | − 0.327 | Moayeri 2016 [51] | ||
| Renal | − 0.260 | Cooper 2020 [52] |
DMARD disease-modifying anti-rheumatic drug, ER emergency department, OCS oral corticosteroid, SF-6D Short form-six dimension, SLE systemic lupus erythematosus, USD United States dollar
aUsing dispensing data from specialty pharmacies, from the last 12 months as of March 29, 2019
bBased on the Work Productivity and Activity Impairment Questionnaire