Glucocorticoid Use in Patients With Systemic Lupus Erythematosus: Association Between Dose and Health Care Utilization and Costs

Arthritis Care & Research
Shih-Yin ChenMatthew H Liang

Abstract

To investigate the determinants of health care utilization and costs with use of glucocorticoid (GC) drugs among adult systemic lupus erythematosus (SLE) patients. This cross-sectional study analyzed established SLE patients identified by International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes from a large US insurance claims database in 2007-2011. Five patient groups were defined by their oral GC use during a 1-year period: non-GC users, <60 days of GC use, and ≥60 days of GC use in low dosage (≤7.5 mg/day), medium dosage (>7.5 to ≤15 mg/day), or higher dosage (>15 mg/day). Annual health care utilization and costs were compared across these groups. Incremental costs of GC groups, calculated as the difference in total health care costs compared with those of the non-GC group, were estimated from multivariable regressions adjusting for demographic/clinical characteristics and stratified by concomitant immunosuppressant use. A total of 50,230 SLE patients were identified (52% non-GC users, 20% <60 days of GC use, and 10% low dose, 10% medium dose, and 8% higher dose of ≥60 days of GC use). GC users had higher health care utilization and costs. Incremental costs were significant (all P < 0.0...Continue Reading

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Citations

Dec 25, 2015·Nature Reviews. Rheumatology·Sarah A Jones, Eric F Morand
Nov 24, 2016·Nature Reviews. Gastroenterology & Hepatology·Medha SoowamberChristian Pagnoux
May 19, 2017·Current Opinion in Rheumatology·Megan R W Barber, Ann E Clarke
Jan 17, 2019·The Journal of Rheumatology·Javier Merayo-ChalicoDiana Gómez-Martín
Jan 4, 2017·Journal of Immunology Research·Liuye HuangZhongwei Zhang
Jul 2, 2020·Open Access Rheumatology : Research and Reviews·Laura Bartels-PeculisWinnie W Nelson
Apr 3, 2019·Immunological Medicine·Tsuneo Kondo, Koichi Amano

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