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dc.contributor.authorBarber, Megan RWen
dc.contributor.authorHanly, John Gen
dc.contributor.authorSu, Lien
dc.contributor.authorUrowitz, Murray Ben
dc.contributor.authorSt Pierre, Yvanen
dc.contributor.authorRomero-Diaz, Juanitaen
dc.contributor.authorGordon, Carolineen
dc.contributor.authorBae, Sang-Cheolen
dc.contributor.authorBernatsky, Sashaen
dc.contributor.authorWallace, Daniel Jen
dc.contributor.authorMerrill, Joan Ten
dc.contributor.authorIsenberg, David Aen
dc.contributor.authorRahman, Anisuren
dc.contributor.authorGinzler, Ellen Men
dc.contributor.authorPetri, Michelleen
dc.contributor.authorBruce, Ian Nen
dc.contributor.authorDooley, Mary Aen
dc.contributor.authorFortin, Paul Ren
dc.contributor.authorGladman, Dafna Den
dc.contributor.authorSanchez-Guerrero, Jorgeen
dc.contributor.authorSteinsson, Kristjanen
dc.contributor.authorRamsey-Goldman, Rosalinden
dc.contributor.authorKhamashta, Munther Aen
dc.contributor.authorAranow, Cynthiaen
dc.contributor.authorMackay, Megganen
dc.contributor.authorAlarcón, Graciela Sen
dc.contributor.authorManzi, Susanen
dc.contributor.authorNived, Olaen
dc.contributor.authorJönsen, Andreasen
dc.contributor.authorZoma, Asad Aen
dc.contributor.authorvan Vollenhoven, Ronald Fen
dc.contributor.authorRamos-Casals, Manuelen
dc.contributor.authorRuiz-Irastorza, Guillermoen
dc.contributor.authorLim, S Samen
dc.contributor.authorKalunian, Kenneth Cen
dc.contributor.authorInanc, Muraten
dc.contributor.authorKamen, Diane Len
dc.contributor.authorPeschken, Christine Aen
dc.contributor.authorJacobsen, Sørenen
dc.contributor.authorAskanase, Ancaen
dc.contributor.authorFarewell, Vernonen
dc.contributor.authorStoll, Thomasen
dc.contributor.authorBuyon, Jillen
dc.contributor.authorClarke, Ann Een
dc.date.accessioned2019-10-01T23:30:37Z
dc.date.available2019-10-01T23:30:37Z
dc.date.issued2020-12en
dc.identifier.issn2151-464X
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/297337
dc.description.abstractObjectives: There is a paucity of data regarding healthcare costs associated with damage accrual in systemic lupus erythematosus (SLE). We describe costs associated with damage states across the disease course using multi-state modeling. Methods: Patients from 33 centres in 11 countries were enrolled in the Systemic Lupus International Collaborating Clinics (SLICC) inception cohort within 15 months of diagnosis. Annual data on demographics, disease activity, damage (SLICC/American College of Rheumatology (ACR) Damage Index [SDI]), hospitalizations, medications, dialysis, and selected procedures were collected. Ten-year cumulative costs (Canadian dollars) were estimated by multiplying annual costs associated with each SDI state by the expected state duration using a multi-state model. Results: 1687 patients participated, 88.7% female, 49.0% of Caucasian race/ethnicity, mean age at diagnosis 34.6 years (SD 13.3), and mean follow up 8.9 years (range 0.6-18.5). Annual costs were higher in those with higher SDIs (SDI ≥ 5: $22 006 2019 CDN, 95% CI $16 662, $27 350 versus SDI=0: $1833, 95% CI $1134, $2532). Similarly, 10-year cumulative costs were higher in those with higher SDIs at the beginning of the 10-year interval (SDI ≥ 5: $189 073, 95% CI $142 318, $235 827 versus SDI=0: $21 713, 95% CI $13 639, $29 788). Conclusion: Patients with the highest SDIs incur 10-year cumulative costs that are almost 9-fold higher than those with the lowest SDIs. By estimating the damage trajectory and incorporating annual costs, damage can be used to estimate future costs, critical knowledge for evaluating the cost-effectiveness of novel therapies.
dc.format.mediumPrinten
dc.languageengen
dc.publisherWiley-Blackwell
dc.rightsAll rights reserved
dc.rights.uri
dc.subjectHumansen
dc.subjectLupus Erythematosus, Systemicen
dc.subjectDisease Progressionen
dc.subjectAntirheumatic Agentsen
dc.subjectImmunosuppressive Agentsen
dc.subjectGlucocorticoidsen
dc.subjectTreatment Outcomeen
dc.subjectRemission Inductionen
dc.subjectModels, Economicen
dc.subjectLongitudinal Studiesen
dc.subjectTime Factorsen
dc.subjectAdulten
dc.subjectMiddle Ageden
dc.subjectCost-Benefit Analysisen
dc.subjectDrug Costsen
dc.subjectFemaleen
dc.subjectMaleen
dc.subjectYoung Adulten
dc.titleEconomic Evaluation of Damage Accrual in an International Systemic Lupus Erythematosus Inception Cohort Using a Multistate Model Approach.en
dc.typeArticle
prism.endingPage1808
prism.issueIdentifier12en
prism.publicationDate2020en
prism.publicationNameArthritis care & researchen
prism.startingPage1800
prism.volume72en
dc.identifier.doi10.17863/CAM.44386
dcterms.dateAccepted2019-10-08en
rioxxterms.versionofrecord10.1002/acr.24092en
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden
rioxxterms.licenseref.startdate2020-12en
dc.contributor.orcidSu, Li [0000-0003-0919-3462]
dc.contributor.orcidUrowitz, Murray B [0000-0001-7506-9166]
dc.contributor.orcidGordon, Caroline [0000-0002-1244-6443]
dc.contributor.orcidIsenberg, David A [0000-0001-9514-2455]
dc.contributor.orcidPetri, Michelle [0000-0003-1441-5373]
dc.contributor.orcidvan Vollenhoven, Ronald F [0000-0001-6438-8663]
dc.contributor.orcidRuiz-Irastorza, Guillermo [0000-0001-7788-1043]
dc.contributor.orcidBuyon, Jill [0000-0002-3852-7129]
dc.contributor.orcidClarke, Ann E [0000-0002-3112-9646]
dc.identifier.eissn2151-4658
rioxxterms.typeJournal Article/Reviewen
cam.orpheus.successThu Jan 30 10:37:48 GMT 2020 - Embargo updated*
rioxxterms.freetoread.startdate2020-10-14


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