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Estimates of the Direct Cost Per Case and Overall Burden of Trichomoniasis for the Employer-Sponsored Privately Insured Women Population in the United States, 2001 to 2005

Owusu-Edusei, Kwame Jr PHD*; Tejani, Mehul N. MD, MPH; Gift, Thomas L. PHD*; Kent, Charlotte K. PHD*; Tao, Guoyu PHD*

Sexually Transmitted Diseases: June 2009 - Volume 36 - Issue 6 - p 395-399
doi: 10.1097/OLQ.0b013e318199d5fe

Background: Little is known about the direct medical cost and overall burden of trichomoniasis among women in the United States.

Methods: We extracted insurance claims for trichomoniasis for 2001 to 2005 from the MEDSTAT MarketScan database using International Classification of Diseases, ninth revision codes. The analysis was restricted to outpatient care and prescription drug claims for women in 4 age categories; under 15, 15 to 24, 25 to 34, and 35 to 64. We used Current Procedures Terminology codes to analyze diagnostic methodologies. All costs were adjusted to 2005 US dollars.

Results: The average outpatient and prescription drug costs per episode for all ages were $97 and $9, respectively. The resulting average total cost per episode was $101 (about 50% did not have drug costs). Average total cost among women aged 15 to 24 years ($120) was significantly (P < 0.01) higher than all other age categories. The estimated annual economic burden was $6.8 million among privately insured women and $18.9 million among all women from the United States. The incidence rate for female enrollees (all ages) having claims was 91 per 100,000 enrollees. Incidence rates were highest for women aged 25 to 29 years (185 per 100,000), followed by women aged 20 to 24 years (166 per 100,000). The most common diagnostic procedure seemed to be wet mount, but nonspecificity of Current Procedures Terminology codes inhibited the analysis of diagnostic methodologies.

Conclusion: The estimated economic burden was highest among reproductive age women (15–34 years). Our estimated economic burden represents a lower-bound estimate because it was based on direct medical costs only.

The estimated average medical cost per episode of trichomoniasis was $101 and the annual economic burden was $6.8 million for the employer-sponsored privately insured women in the United States.

From the *Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; and †Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

The findings and conclusions in this manuscript are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention (CDC). Mention of company names or products does not imply endorsement by CDC.

Correspondence: Kwame Owusu-Edusei Jr., PhD, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road MS E-80, Atlanta, GA 30333. E-mail:

Received for publication October 16, 2008, and accepted December 8, 2008.

© Copyright 2009 American Sexually Transmitted Diseases Association