Estimating the Incidence and Prevalence of Juvenile-Onset Recurrent Respiratory Papillomatosis in Publicly and Privately Insured Claims Databases in the United States

Marsico, Mark MPH*; Mehta, Vinay PhD*; Chastek, Benjamin MS; Liaw, Kai-Li PhD*; Derkay, Craig MD

Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0000000000000115
Original Study

Background: Juvenile-onset recurrent respiratory papillomatosis (JORRP) is a chronic disease caused by human papillomavirus types 6 and 11. It is associated with significant morbidity that places intense physical, psychological, and financial strain on patients and their families. Few studies have assessed the incidence and prevalence of JORRP in the United States.

Methods: This retrospective, longitudinal cohort study was performed using data from a pair of large insurance claims databases in the United States. The Optum Clinformatics and Truven MarketScan Medicaid databases represent a sample of privately and publicly insured children, respectively. Cohorts of children aged 0 to 17 years were created within each database to estimate the incidence and prevalence of JORRP in 2006. Claims-based algorithms were designed to capture as many potential cases as possible. To improve the accuracy of the incidence and prevalence estimates, chart validation was performed to estimate the positive predictive value (PPV) of the claims-based algorithms.

Results: The overall PPV-adjusted incidence of JORRP in 2006 was 0.51 per 100,000 in Optum and 1.03 per 100,000 in the MarketScan Medicaid population. Peak incidence was observed among 0- to 4-year-olds in both databases. The PPV-adjusted prevalence of JORRP in 2006 was 1.45 and 2.93 per 100,000 in the Optum and MarketScan Medicaid cohorts, respectively.

Conclusions: Although relatively uncommon, JORRP represents a disease with significant morbidity. The incidence and prevalence of JORRP in publicly insured children were consistently higher than those covered by private insurance plans, suggesting an increased burden of illness among those with lower socioeconomic status.

In Brief

A study using insurance claims data and medical chart review estimated the prevalence of juvenile-onset recurrent respiratory papillomatosis as 1.45 and 2.93 per 100,000 in privately and publicly insured children, respectively.

Author Information

From the *Epidemiology Department, Merck Research Laboratories, North Wales, PA; †OptumInsight, Eden Prairie, MN; and ‡Department of Otolaryngology, Pediatric Otolaryngology, Eastern Virginia Medical School Children’s Hospital of the King’s Daughters, Norfolk, VA

Acknowledgments: Medical writing and/or editorial assistance was provided by Scott Vuocolo, PhD, and Karyn Davis of Merck. This assistance was funded by Merck, Whitehouse Station, NJ.

Funding source: Merck & Co, Inc, funded this study.

Conflict of interest: B.C. is an employee of Optum, which was hired by Merck to conduct the study. M.M., V.M., and K.L.L. are employees of Merck and may own stock and/or stock options.

Correspondence: Mark Marsico, MPH, Epidemiology Department, Merck Research Laboratories, 351 N Sumneytown Pike, UG-1D60, North Wales, PA 19454. E-mail:

Received for publication July 31, 2013, and accepted February 10, 2014.

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