Systemic lupus erythematosus (SLE) is a debilitating disease that often robs young people of being fully productive during their work years. Now, researchers at the University of California, San Francisco (UCSF) have determined just how much lupus contributes to increased health care costs and lost work productivity.
The researchers used data from UCSF's Lupus Outcomes Study, obtaining information on health care resource use and employment on 812 participants. Estimates of health care costs associated with lupus were also analyzed. The researchers measured changes in the number of hours worked since receiving a diagnosis of lupus in order to calculate productivity costs. Since lupus affects women mostly, the majority of subjects in the study (92.6 percent) were female.
Almost all of the participants (99.9 percent) had seen a physician at least once in the past year; 21 percent were hospitalized at least once. More than a third (39 percent) had visited the emergency department (ED) at least one time. Only 2.6 percent received dialysis in the previous year. Total direct health care costs for each participant were $12,643. Almost half of this ($6,153) was due to hospital admissions. Medications accounted for 25.7 percent of the total cost, while physician visits were responsible for 11.6 percent.
At the time of their lupus diagnosis, 76.8 percent of individuals were employed. This employment rate dropped to under half (48.7 percent) by the time they participated in the study. The number of annual working hours also decreased among those still working. Mean income at the time of diagnosis was $24,931; at study entry, it had declined to $16,272. Participants with the highest level of disease activity incurred almost double the direct health care costs than those with the lowest level ($16,761 vs. $9,501). Factors predicting higher costs included greater disease activity, longer disease duration, and worse physical and mental health status. The study was supported in part by the Agency for Healthcare Research and Quality (HS13893).
See "Health care costs and costs associated with changes in work productivity among persons with systemic lupus erythematosus," by Pantelis Panopalis, M.D., Jinoos Yazdany, M.D., M.P.H., JoAnn Zell Gillis, M.D., and others, in the December 2008 Arthritis & Rheumatism (Arthritis Care & Research) 59(12), pp. 1788-1795.