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Direct and Indirect Costs to Employers of Patients With Systemic Lupus Erythematosus With and Without Nephritis

Carls, Ginger MA; Li, Tracy PhD; Panopalis, Pantelis MD; Wang, Shaohung PhD; Mell, Amy G. MPH; Gibson, Teresa B. PhD; Goetzel, Ron Z. PhD

Journal of Occupational and Environmental Medicine: January 2009 - Volume 51 - Issue 1 - p 66-79
doi: 10.1097/JOM.0b013e31818a405a
Original Articles: Special Section on Climate Change and Health

Objectives: To estimate the medical- and productivity-related cost burden of systemic lupus erythematosus (SLE) and SLE with nephritis in an employee population.

Methods: Using administrative data, annual costs were calculated for SLE patients, a subset with nephritis, and a matched control group of patients without SLE. These costs were compared with the cost of other chronic conditions.

Results: Mean annual medical expenditures and short term disability costs for SLE patients were $12,238 and $1184 greater (2005 dollars), respectively, than those of controls. Mean medical expenditures for SLE/nephritis patients were $46,862 greater than for controls. When compared with other chronic health conditions faced by employees, SLE/nephritis was the most costly condition.

Conclusions: SLE, particularly with nephritis, is associated with substantial costs. Therapies that can better manage SLE may provide opportunities for savings to employers.

From the Health and Productivity Division, Thomson Healthcare, Ann Arbor, Mich (Ms Carls, Dr Gibson, Ms Mell), Cambridge, Mass (Dr Wang), and Washington, DC (Dr Goetzel); Global Outcomes Research (Dr Li), Bristol-Myers Squibb, Princeton, NJ; Rheumatology (Dr Panopalis), University of California San Francisco, San Francisco, Calif; Institute for Health and Productivity Studies (Dr Goetzel), Rollins School of Public Health, Emory University, Atlanta, Ga.

Address correspondence to: Ginger Carls, MA, 777 E. Eisenhower Parkway, Ann Arbor, MI 48108; E-mail:

©2009The American College of Occupational and Environmental Medicine