Even with several metric reports available, Michelle Petri, MD, MPH, explains that measuring the outcomes of systemic lupus erythematosus (SLE) is difficult.
Dr Petri explains that measuring outcomes is challenging because multiple organ sites are involved; and because the disease presents in many different ways, healthcare professionals often utilize available indexes as research tools.
Instead of referring to a single guideline when making treatment decisions, healthcare professionals assess these metrics in combination.
Additionally, a correct diagnosis often does not occur until after the disease has become full-fledged. Generally, a patient first seeks the opinion of his or her primary care physician. Often, by the time a correct diagnosis is made with a specialist such as a rheumatologist, the disease has caused permanent damage. Therefore, Dr Petri believes it is necessary to address this issue by enforcing rapid referral to academic rheumatology practices.
Furthermore, Maria Lopes, MD, MS, explains that another challenge to the treatment of SLE, even with the availability of national guidelines, is the overall cost of treatment. Dr Petri agrees and explains that the approval of Benlysta (belimumab), the first biologic approved for lupus, is very expensive due to results of clinical trials that revealed only a 10% difference in outcomes between the group treated with Benlysta and the standard-of-care group.
Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
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