OBJECTIVES: Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus (SLE); patients can experience permanent kidney damage requiring dialysis and transplantation (end-stage kidney disease [ESKD]). This study assessed healthcare resource utilisation (HCRU) and the economic burden of LN in mainland China.
METHODS: This retrospective real-world study (GSK Study 214114) in patients with a history of LN utilised the 2017 China Health Insurance Research Association National Claims Database. Patients with LN were identified using LN diagnosis keywords and a combination of SLE and LN ICD-10 codes; index was the date of first medical claim with an SLE and/or LN diagnosis since January 1, 2017, with a maximum of 1-year follow-up until December 31, 2017. All-cause and disease-specific (SLE and/or LN) HCRU and costs were evaluated (calculated per-patient-per-month [PPPM] to account for variable follow-up).
RESULTS: Overall, 404 patients with LN were identified; 83% were female, mean (standard deviation [SD]) age was 45.02 (16.31) years, and 142 (35%) had ESKD. Among patients with LN, 61% had ≥1 disease-specific inpatient admission; mean (SD) stay was 3.03 (4.01) days PPPM. Disease-specific total medical costs (mean [SD]: 2411.59 [4402.35] Chinese yuan renminbi [CNY] PPPM) were driven by inpatient services (80% of total), with a mean (SD) cost of 8227.77 (14,158.35) CNY per inpatient admission. Compared with patients without ESKD, patients with ESKD had over 2-fold longer inpatient stays PPPM (mean [SD]: 4.77 [5.76] vs 2.22 [2.47] days), incurred over 2-fold higher disease-specific total medical costs PPPM (mean [SD]: 3634.25 [5854.41] vs 1748.93 [3186.68] CNY), and had approximately 1.5-fold higher costs per inpatient admission (mean [SD]: 10,046.13 [16,462.42] vs 6610.99 [11,516.66] CNY).
CONCLUSIONS: In China, patients with LN, particularly those with ESKD, incur substantial HCRU and economic burden, highlighting a need for early diagnosis and more effective interventions to prevent progression of renal disease.
