Introduction

Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that can severely affect a person’s physical and mental well-being, social life and ability to acquire and maintain gainful employment. It is a condition that is characterised by frequent exacerbations that can affect virtually any organ system. Over time, damage to vital organs may ensue as a result of the disease itself or as a consequence of treatment. Patients experiencing the unpredictable and often severe manifestations of SLE often require substantial health-care resources and incur considerable health-care costs. Furthermore, the propensity of SLE to predominantly affect women in young and middle adulthood, at a time in their lives when they are establishing careers and starting a family, can have important consequences with respect to acquiring and maintaining employment, remaining productive in the workforce and advancing in one’s career.

The scope of this current review is to provide a picture of our current understanding of the economic burden that SLE has on patients and on society as a whole. The first part of the review focusses on health-care costs, also referred to as direct costs. Over the past few years, several studies have demonstrated that patients with SLE, when compared to persons without SLE, are heavier consumers of health-care resources and incur substantial health-care costs. Although these studies do have their limitations, they help shed light on how health-care resources are used in SLE and what predicts increased costs. This information helps policy makers in their efforts to allocate health-care resources in a manner that could control costs while ensuring the best outcomes. The second part of this review focusses on the impact of SLE on rates of employment and disability, work productivity and the costs of work productivity loss. A number of recent studies are reviewed that demonstrate employment rates among persons with SLE, predictors of work disability and how persons with SLE enter and exit the workforce. The monetary costs associated with work loss and diminished productivity, also referred to as indirect costs, are reviewed.