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Abstract：
To estimate the annual direct costs and cost-drivers associated with systemic lupus erythematosus (SLE) patients in China.
A multi-center, cross-sectional study was conducted based on the CSTAR registry. The information on demography and expenditures for outpatient and inpatient visits due to SLE were collected using online questionnaires. These patients\' medical records were from the database of the Chinese Rheumatology Information System (CRIS). The average direct costs and 95% confidence interval were estimated using the bootstrap method with 1000 bootstrap samples by resampling with replacement. The cost-drivers were identified using multivariate regression models.
A total of 1778 SLE patients from 101 hospitals participated in our study, with 92.58% as females, a mean age of 33.8 years old, a median duration of SLE of 4.9 years, 63.8% in an active disease state, 77.3% with two organs or more damaged, and 8.3% using biologics as treatment. The average annual direct cost per patient was estimated at CNY 29,727, which approximates to 86% for direct medical costs. For moderate to severe disease activities, the use of biologics, hospitalization, treatment of moderate or high dose glucocorticoids, and peripheral vascular, cardiovascular, and/or renal system involvements were found to substantially increase the direct costs, while health insurance slightly decreased the direct costs of SLE.
This study provided reliable insight into financial pressures on individual SLE patients in China. The efforts focusing on preventing flare occurrences and limiting disease progression were recommended to further reduce the direct cost of SLE.
A multi-center, cross-sectional study was conducted based on the CSTAR registry. The information on demography and expenditures for outpatient and inpatient visits due to SLE were collected using online questionnaires. These patients\' medical records were from the database of the Chinese Rheumatology Information System (CRIS). The average direct costs and 95% confidence interval were estimated using the bootstrap method with 1000 bootstrap samples by resampling with replacement. The cost-drivers were identified using multivariate regression models.
A total of 1778 SLE patients from 101 hospitals participated in our study, with 92.58% as females, a mean age of 33.8 years old, a median duration of SLE of 4.9 years, 63.8% in an active disease state, 77.3% with two organs or more damaged, and 8.3% using biologics as treatment. The average annual direct cost per patient was estimated at CNY 29,727, which approximates to 86% for direct medical costs. For moderate to severe disease activities, the use of biologics, hospitalization, treatment of moderate or high dose glucocorticoids, and peripheral vascular, cardiovascular, and/or renal system involvements were found to substantially increase the direct costs, while health insurance slightly decreased the direct costs of SLE.
This study provided reliable insight into financial pressures on individual SLE patients in China. The efforts focusing on preventing flare occurrences and limiting disease progression were recommended to further reduce the direct cost of SLE.
摘要：
背景：评估与中国系统性红斑狼疮（SLE）患者相关的年度直接费用和费用驱动因素。
方法：多中心，横断面研究基于CSTAR注册进行.使用在线问卷收集了由于SLE引起的门诊和住院就诊的人口统计学和支出信息。这些患者的病历来自中国风湿病信息系统（CRIS）的数据库。平均直接成本和95％置信区间是使用Bootstrap方法对1000个Bootstrap样本进行重新采样并替换估算的。使用多元回归模型确定了成本驱动因素。
结果：共有来自101家医院的1778名SLE患者参与了我们的研究，92.58%为女性，平均年龄33.8岁,SLE的中位持续时间为4.9年，63.8%处于活跃的疾病状态，77.3%有两个器官或以上受损，8.3%使用生物制剂作为治疗。每位患者的平均年直接费用估计为29,727元，直接医疗费用约为86％。对于中度至重度疾病活动，生物制剂的使用，住院治疗,中等或高剂量糖皮质激素的治疗，和外周血管，心血管,和/或肾脏系统受累被发现大大增加了直接成本，而医疗保险略微降低了SLE的直接成本。
结论：这项研究为中国SLE患者个体的经济压力提供了可靠的见解。建议将重点放在预防发作和限制疾病进展上，以进一步降低SLE的直接成本。
方法：多中心，
结果：共有来自101家医院的1778名SLE患者参与了我们的研究，
结论：这项研究为中国SLE患者个体的经济压力提供了可靠的见解。
