Assessing incidence and economic burden of genital warts with data from a US commercially insured population

ABSTRACT

Objective: This study examined the incidence of and healthcare costs attributable to genital warts within a large US commercially insured, geographically dispersed population.

Research design and methods: Using a retrospective cohort study design, this longitudinal analysis assessed administrative claims of integrated medical and pharmacy encounters from five Blue Cross Blue Shield health plans. Genital warts cases were identified using a methodology previously described by Insinga et al.

Main outcome measures: Age- and gender-specific incidence of genital warts per 1000 person-years in 2004, and duration-of-episode attributable direct medical costs (2004 US dollars) and healthcare resource utilization of cases diagnosed in 2002. Overall outcome measures were age- and gender-adjusted to the 2004 US civilian population.

Results: Genital warts incidence in 2004 was 1.2/1000 females and 1.1/1000 males. Incidence was highest among females aged 20–24 (4.6/1000) and males aged 25–29 (2.7/1000). Projected overall incidence was over 340 000 cases in 2004. Mean duration-of-episode per incident case in 2002 was 95.4 days (males 116.3 days; females 69.7 days). Mean ambulatory visits per episode were 1.5 for females and 1.9 for males, with <1 drug prescription/episode. Mean costs were $647/episode ($745 males; $528 females). The 2004 estimated economic burden was $760 per 1000 individuals in the general population with the total exceeding $220 million.

Limitations: Only those genital warts cases that sought evaluation or for which the treating provider was covered by the health plan were captured in the study.

Conclusions: Genital warts represent a significant health and cost burden in the US. Adoption of novel healthcare technologies such as vaccines along with traditional interventions such as physician education of signs and symptoms, condom use and abstinence or limiting number of sexual partners may significantly help reduce the burden of genital warts.

Key words: :

• Costs
• Epidemiology
• Genital warts
• Incidence
• Managed care

Transparency

Declaration of funding

The research described in this manuscript was supported by funding from Merck & Co., Inc.

Declaration of financial/other relationships

R.P.I. and P.K.S. have disclosed that they are employees of Merck and also Merck stockholders. Merck is the manufacturer of Gardasil, the quadrivalent HPV types 6, 11, 16, 18 vaccine that targets genital warts.

All peer reviewers receive honoraria from CMRO for their review work. The peer reviewers have disclosed that they have no relevant financial relationships.

Acknowledgment

The authors acknowledge Patti Peeples, RPh, PhD, of HealthEconomics.com for her assistance in writing earlier versions of this manuscript.

Data presented in this paper were previously presented in an Abstract presented at the Medical Leadership Forum of the America's Health Insurance Plans, Phoenix, AZ, USA, November 1–3, 2006: The incidence and health care costs of genital warts in a commercially insured population.