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Objectives: To evaluate health care utilization and costs for patients with systemic lupus erythematosus (SLE) by disease severity. Methods: We searched PubMed and Embase from January 2000 to June 2020 for observational studies examining health care utilization and costs associated with SLE among adults in the United States. Two independent reviewers reviewed the selected full-text articles to determine the final set of included studies. Costs were converted to 2020 US $. Results: We screened 9224 articles, of which 51 were included. Mean emergency department visits were 0.3–3.5 per year, and mean hospitalizations were 0.1–2.4 per year (mean length of stay 0.4–13.0 days). Patients averaged 10–26 physician visits/year. Mean annual direct total costs were $17,258–$63,022 per patient and were greater for patients with moderate or severe disease ($19,099–$82,391) compared with mild disease ($12,242–$29,233). Mean annual direct costs were larger from commercial claims ($24,585–$63,022) than public payers (Medicare and Medicaid: $18,302–$27,142). Conclusions: SLE remains a significant driver of health care utilization and costs. Patients with moderate to severe SLE use more health care services and incur greater direct and indirect costs than those with mild disease. [ABSTRACT FROM AUTHOR]

Introduction and Objective: The National Cholesterol Education Program recommends regular physician follow-up and lipid testing to promote adherence with lipid-lowering medications. The objective of this study was to determine whether lipid tests and physician visits after treatment initiation are indeed associated with adherence to statin therapy. Subjects and Methods: A retrospective cohort study was conducted among 19422 enrolees in a US managed care plan who initiated treatment with a statin between October 1999 and August 2001. Computerised pharmacy, medical and laboratory records were used to study the patterns and predictors of adherence with lipid-lowering therapy for up to 3 years. Adherence was assessed in 3-month intervals with patients considered ‘adherent’ if ≥80% of days were covered by lipid-lowering therapy. Results: In the first 3 months, 40% of patients had follow-up lipid tests and only 21% had dyslipidaemia visits (14% had both). Those receiving such care were substantially more likely to be adherent in subsequent intervals. Compared with those without follow-up, the relative odds of adherence were 1.42 and 1.27 for patients with one or more lipid test and one or more dyslipidaemia visit, respectively (95% confidence intervals [CI] 1.33, 1.50 and 1.16, 1.39). Patients who received a follow-up visit and lipid test were 45% more likely to be adherent (95% CI 1.34, 1.55). Similar associations were observed when lipid tests and dyslipidaemia visits occurred later in therapy. Conclusion: Early and frequent follow-up by physicians – especially lipid testing – was associated with improved adherence to lipid-lowering therapy. A randomised prospective study is needed to determine whether this relationship is causal. [ABSTRACT FROM AUTHOR]