Clarke, Ann E;
Hanly, John G;
Urowitz, Murray B;
St Pierre, Yvan;
Gordon, Caroline;
Bae, Sang-Cheol;
Romero-Diaz, Juanita;
... Farewell, Vernon; + view all
(2023)
Assessing the Costs of Neuropsychiatric Disease in the Systemic Lupus International Collaborating Clinics (SLICC) Cohort using Multistate Modelling.
Arthritis Care & Research
, 75
(9)
pp. 1859-1870.
10.1002/acr.25090.
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Abstract
OBJECTIVE: To estimate direct and indirect costs (DC, IC) associated with neuropsychiatric (NP) events in the SLICC Inception Cohort. METHODS: NP events were documented annually using ACR NP definitions and attributed to SLE or non-SLE causes. Patients were stratified into one of three NP states (no, resolved, or new/ongoing NP event). Change in NP status was characterized by inter-state transition rates using multi-state modelling. Annual DC and IC were based on healthcare use and impaired productivity over the preceding year. Annual costs associated with NP states and NP events were calculated by averaging all observations in each state and adjusted through random-effects regressions. Five and 10-year costs for NP states were predicted by multiplying adjusted annual costs per state by expected state duration, forecasted using multistate modelling. RESULTS: 1697 patients (49% White race/ethnicity) were followed a mean of 9.6 years. NP events (n=1971) occurred in 956 patients, 32% attributed to SLE. For SLE and non-SLE NP events, predicted annual, five, and 10-year DC and IC were higher in new/ongoing versus no events. DC were 1.5-fold higher and IC 1.3-fold higher in new/ongoing versus no events. IC exceeded DC 3.0 to 5.2-fold. Among frequent SLE NP events, new/ongoing seizure disorder and cerebrovascular disease accounted for the largest increases in annual DC. For non-SLE NP events, new/ongoing polyneuropathy accounted for the largest increase in annual DC and new/ongoing headache and mood disorder for the largest increases in IC. CONCLUSION: Patients with new/ongoing SLE or non-SLE NP events incurred higher DC and IC.
| Type: | Article |
|---|---|
| Title: | Assessing the Costs of Neuropsychiatric Disease in the Systemic Lupus International Collaborating Clinics (SLICC) Cohort using Multistate Modelling |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/acr.25090 |
| Publisher version: | https://doi.org/10.1002/acr.25090 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10163812 |
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