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Economic Burden of Systemic Lupus Erythematosus Flares and Comorbidities in a Commercially Insured Population in the United States

Narayanan, Siva PhD; Wilson, Kathleen MPH; Ogelsby, Alan MPH; Juneau, Paul MS; Durden, Emily PhD

Journal of Occupational and Environmental Medicine: November 2013 - Volume 55 - Issue 11 - p 1262–1270
doi: 10.1097/JOM.0000000000000008
Original Articles

Objective: To estimate the medical and productivity-related cost burden of systemic lupus erythematosus (SLE) flares and comorbidities in a commercially insured population.

Methods: Using administrative data, annual medical costs and indirect costs because of work loss were calculated for adult SLE patients, including flare severity and SLE-related comorbidity subsets, and a matched control group without SLE.

Results: Adjusted annualized medical costs were $18,952, $4305, $914, and $441 greater for SLE patients with severe, moderate, mild, and no flares, respectively, during follow-up than those of the matched controls. Medical costs also varied by SLE-related comorbidity. Adjusted annualized indirect costs of work loss because of absence and short-term disability were $1867 and $1602 greater, respectively, for SLE patients than for controls.

Conclusions: SLE imposes a substantial cost burden to both patients and their employers.

From the Human Genome Sciences and IPSOS (Dr Narayanan), Rockville, MD; Truven Health Analytics (Ms Wilson, Mr Juneau, and Dr Durden), Washington, DC; and GlaxoSmithKline (Mr Ogelsby) Raleigh Durham, NC.

Address correspondence to: Emily Durden, PhD, Truven Health Analytics, 3304 Oakmont Blvd, Austin, TX 78703 (

Supported by funding from Human Genome Sciences and GlaxoSmithKline, USA.

Emily Durden, Kathleen Wilson, and Paul Juneau are employed by Truven Health Analytics, contracted for the design and implementation of the study described herein by Human Genome Sciences and GlaxoSmithKline, USA.

Siva Narayanan was employed by and held stock in Human Genome Sciences at the time the study was conducted. Human Genome Sciences manufactures and markets a treatment for systemic lupus erythematosus.

Alan Ogelsby is employed and holds stock in GlaxoSmithKline, USA.

The authors declare no conflicts of interest. Authors Durden, Narayanan, Wilson, Oglesby, and Juneau have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM Editorial Board and planners have no financial information related to this research.

Copyright © 2013 by the American College of Occupational and Environmental Medicine