For patients with systemic sclerosis, interstitial lung disease and pulmonary arterial hypertension can result in significant increases in health care costs, according to research published in the Journal of Rheumatology.
Aryeh Fischer, MD, lead author of the study and associate professor at the University of Colorado School of Medicine, said his team’s findings suggest there remains an unmet need to identify more effective therapeutic strategies for both interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) in patients with systemic sclerosis (SSc).
“Although lung disease (ILD and/or PAH) is the leading cause of death in SSc, the impact of ILD and PAH on health care costs among patients with SSc has not been well-described,” Fischer told Healio Rheumatology. “As such, this study is important because it adds substantially to what we know about health care costs associated with lung disease in SSc.”
To describe health care costs among patients in the United States with newly diagnosed SSc, as well as those with SSc newly diagnosed with ILD and/or PAH, the researchers conducted a retrospective cohort analysis using the Truven Health MarketScan Commercial and Medicare Supplemental claims databases. Focusing on data from 2003 to 2014, they used the ICD-9 diagnosis codes to classify patients into three groups — incident SSc (n = 1,957), SSc with incident ILD (n = 219; SSc-ILD) and SSC with incident PAH (n = 108; SSc-PAH).
The study required patients to maintain continuous enrollment for 5 years to measure all-cause health care costs. The researchers recorded overall costs, as well as costs by service type and the year following diagnosis.
According to the researchers, the average — defined as mean ± SD — all-cause health care costs over follow-up among patients with incident SSc-ILD was $191,107 (± $322,193), and 254,425 (± $240,497) for patients with incident SSc-PAH. Meanwhile, the average all-cause costs during the same period for patients with incident SSc only was $101,839 (± $167,155). Further, average annual costs over the 5-year period ranged from $18,513 to $23,268 for patients with incident SSc, from $31,285 to $55,446 for patients with incident SSc-ILD, and from $44,454 to $63,320 for patients with incident SSc-PAH, the researchers said. Costs tended to be the highest in the fifth year of follow-up.
“In comparison to those with SSc alone, the presence of ILD and/or PAH is associated with substantial increases in health care costs and a worse survival experience,” Fischer said. “Lung disease – manifesting as ILD and/or PAH – is the leading cause of death in SSc. In addition, the presence of lung disease has a major impact on health care costs in this patient population.” – by Jason Laday
Disclosure: The authors report funding from Genentech Inc. and F. Hoffmann-La Roche Ltd.