Economic Burden among Commercially Insured Patients with Systemic Sclerosis in the United States

Abstract

Objective.To quantify healthcare resource utilization (HRU), work loss, and annual direct and indirect healthcare costs among patients with systemic sclerosis (SSc) compared to matched controls in the United States.Methods.Data were obtained from a large US commercial claims database. Patients were ≥ 18 years old at the index date (first SSc diagnosis) and had ≥ 1 SSc diagnosis in the inpatient (IP) or emergency room (ER) setting, or ≥ 2 SSc diagnoses on 2 different dates in the outpatient (OP) setting between January 1, 2005, and March 31, 2015; continuous enrollment was required during the followup period (12 months after the index date). Individuals with no SSc diagnoses were matched 1:1 to patients with SSc. Wilcoxon signed-rank and McNemar tests were used for comparisons and regressions with generalized estimating equations for adjusted OR (aOR) and incidence rate ratios (IRR) between 2 cohorts.Results.There were 2192 pairs of patients with SSc and matched controls included (mean age 57.6 yrs; 84.3% female); of these, 233 were eligible for work loss/indirect cost analyses. Compared to matched controls, patients with SSc had significantly higher HRU and costs during the 1-year followup period, IP admissions (adjusted IRR = 2.4), IP hospitalization days (adjusted IRR = 3.1), ER visits (adjusted IRR = 2.0), OP visits (adjusted IRR = 2.3), and days of work loss (adjusted IRR = 2.6). The adjusted difference in annual direct and indirect costs was US$12,820 and $3103, respectively (all p < 0.0001).Conclusion.Patients with SSc had a high direct and indirect economic burden postdiagnosis.

Direct and indirect costs of systemic sclerosis and associated interstitial lung disease: A nationwide population‐based cohort study

“…We find that indirect costs contributed markedly to the total costs associated with both ILD‐SSc and non‐ILD SSc, which is in line with previous cross‐sectional studies on productivity loss associated with SSc that found annual costs from €5500 to €10,500 29–32 . A cohort study from the United States evaluated insured and working SSc cases and matched non‐SSc controls and found excess costs of $3103 (€2736) due to productivity loss in the first year following diagnosis 33 . In a subset cohort from the study, a difference of $5846 (€5155) was found between SSc‐ILD cases ( n = 52) and matched non‐SSc controls during 6 months of follow‐up 12 .…”

Soldiering on the Job When Ill: Productivity Costs in Connective Tissue Disease–associated Interstitial Lung Disease

“…The author’s findings complement earlier studies on the epidemic cannibalism of presenteeism over absenteeism on workplace productivity ( 5 , 9 , 10 ) and the potential effect of CTD on labor costs to organizations ( 11 , 12 ). The study underscores that absenteeism and disability costs incompletely gauge the total loss of productivity resulting from CTD-FILD and reminds us about the significance of screening and stopping the detrimental effects of presenteeism on employee patients’ well-being and work engagement before it starts.…”

Telemedicine in rheumatology: a reliable approach beyond the pandemic

“…Patients’ reduced direct access to outpatient clinics, in addition to its actual role in reducing the risk of SARS-CoV-2 spreading, may also be an important tool for easing the economic burden of chronic diseases, a matter not to be ignored in the economic crisis we will face due to COVID-19. Telemedicine could be useful in reducing some indirect costs of the rheumatic diseases, like the loss of working days for patients and/or caregivers [ 11 , 12 ], and on the other hand it may favour a more rapid access to the clinic for those urgent and acute conditions that cannot be addressed by telemedicine alone [ 13 ]. Moreover, the use of other available technology resources may increase the continuity of patient monitoring through the use of dedicated apps, and the ability to report day-by-day conditions, symptoms and signs [ 14 ].…”