JAMA Netw Open

Early belimumab offers more benefit at lower cost in lupus model

February 24, 2026

A 15‑year Markov model of biologic‑naive adults with active systemic lupus erythematosus (SLE) found that initiating belimumab within 2 years of disease onset increased quality-adjusted life-years (QALYs) by 0.30 and reduced total direct medical costs by about $126,000 per patient compared with delaying therapy. Early initiation was favored in 81% of simulations and yielded a strongly dominant incremental cost-effectiveness ratio (–$421,124 per QALY). The model attributes savings to earlier reduction in disease activity, flares, and organ damage.

Clinical takeaway: For patients with active, autoantibody‑positive SLE, earlier belimumab initiation may offer substantial long‑term clinical and economic advantages relative to waiting for refractory disease.

Source:

Hundal S, et al. (2026, February 19). JAMA Netw Open. Cost-Effectiveness of Early vs Delayed Belimumab Treatment for Systemic Lupus Erythematosus. https://pubmed.ncbi.nlm.nih.gov/41712207/