Estimating the Direct Outpatient Medical Cost per Episode of Primary and Secondary Syphilis in the United States: Insured Population Perspective, 2003–2007

Abstract

No study has directly estimated the direct outpatient medical cost of care for primary and secondary (P&S) syphilis among the employer-sponsored commercially insured population in the United States. We used international classification of diseases, ninth revision (ICD-9) codes to identify outpatient claims for persons diagnosed with P&S syphilis for 2003 through 2007 from the MarketScan database. Diagnostic test costs were also analyzed using current procedural terminology codes for syphilis tests. We used healthcare common procedure coding system (HCPCS) codes to identify and analyze parenteral treatment costs for those diagnosed with P&S syphilis. Potential oral drug regimen was also investigated for those diagnosed using national drug codes. All costs were adjusted to 2007 US dollars. Overall costs estimates were categorized into males and females. The overall average cost per episode of P&S syphilis on an outpatient basis was $194. Further analyses indicated that the estimated average cost per case of P&S syphilis diagnosed and treated parenterally on an outpatient basis was $229. We did not find any significant difference between the total average costs for males and females. However, the cost per parenteral treatment was significantly higher (P<0.05) for males ($54) than those for females ($39). The estimate reported in this study represents a lower-bound estimate because it was based on direct medical cost only and does not include other associated costs such as pain and suffering nor lost productivity.