Healthcare utilization and costs following molecular diagnostic testing among patients with vaginitis.

Abstract

Aim: Vaginitis and other vaginal discharge syndromes lead to high healthcare utilization. Molecular tests like syndromic multiplex real-time (RT) polymerase chain reaction (PCR)-based tests are highly sensitive and specific at diagnosing the infectious causes of vaginitis. This study compared the healthcare resource utilization (HCRU) and direct all-cause healthcare costs among patients with vaginitis in the US receiving next-day syndromic multiplex RT-PCR tests with those receiving other PCR tests or no diagnostic test of interest. Patients & methods: This retrospective study utilized claims data from IQVIA PharMetrics® Plus database to identify adult patients with a diagnosis for vaginitis (first claim=index) from January 2021 to April 2023, with 6months of continuous enrollment prior to (baseline) and after index (follow-up). Pairwise comparisons were conducted between RT-PCR and 1:1 propensity matched Other PCR and No Test subcohorts for all-cause HCRU and costs during follow-up. Results: Each of the RT-PCR, Other PCR and No Test subcohorts included 1946 matched patients. Mean(SD) follow-up total cost was significantly lower for the RT-PCR than the No Test subcohort ($5607[$15,122] vs $6680[$20,751], p=0.0023). Mean(SD) overall outpatient and other medical service costs were lower for RT-PCR versus Other PCR (outpatient: $2964[$9666] vs $3174[$7113], p=0.0110; other medical: $1961[$9244] vs $2099[$6475], p=0.0002) and No Test subcohorts (outpatient: $2964 [$9666] vs $4067[$12,341], p<0.0001; other medical: $1961[$9244] vs $2973[$11,685]; p<0.0001). A lower proportion had any outpatient service HCRU in RT-PCR versus Other PCR subcohort (92.6% vs 94.2%, p=0.0349). A lower proportion had any other medical service claim in RT-PCR versus Other PCR (78.3% vs 83.2%, p<0.0001) and No Test subcohorts (78.3% vs 83.0%, p=0.0001). Physician office, emergency room (ER), prescription use and costs were similar between the subcohorts. Conclusion: The use of syndromic multiplex RT-PCR diagnostics with next day test results in patients with vaginitis was associated with lower outpatient costs and total healthcare costs than those in the no test cohort over 6months. These findings indicate that use of syndromic multiplex RT-PCR diagnostics may contribute to improved patient management compared with clinical diagnosis alone.