Treatment Patterns, Healthcare Resource Utilization (HCRU), and Direct Costs for Bacterial Vaginosis (BV) in US Commercially Insured Populations

OBJECTIVES: To describe treatment patterns, HCRU and costs, overall and by treatment course, among commercially insured women in the US with BV.

METHODS: The Merative™ MarketScan® Commerical Database was used to conduct a retrospective cohort analysis. The study included women 12 to 49 years of age with an incident BV diagnosis from 1 January 2017 to 30 September 2020 and a claim for at least one BV medication. The first treatment course (TC) was defined as any patient who had one BV treatment, as evidenced by a pharmacy claim. Additional treatment courses were accounted for within a year. Baseline and follow-up periods were 12 months before and after diagnosis, respectively.

RESULTS: There were 140,826 women with an incident BV diagnosis. At baseline, mean age was 31 years, and 24% (n = 33,266) had BV-associated complications at baseline of which 8% were sexually transmitted infections (STI). Overall, 64% of women had 1 TC, 22% had 2 TCs, 8% had 3 TCs and 6% had ≥ 4 TCs. Metronidazole oral (74%) was most frequently prescribed. However, the proportion of women who were prescribed clindamycin (vaginal) increased from first (4%) to third TC (7%). During follow-up, median total direct all-cause and BV-related cost per patient per year were $3,151.11 and $258.44, respectively. Median total cost for all-cause and BV-related HCRU ranged from $2,867.89 and $219.20 in patients with 1 TC to $4,283.54 and $557.54 in patients with ≥ 4 TCs, respectively. The average number of claims for all-cause physician’s visits were also higher among women with ≥ 4 TCs (12.99) when compared to 1 TC (9.93).

CONCLUSIONS: In this study 36% (n = 50,466) of woman had recurrent BV within a year of follow-up. Effective treatment to prevent BV recurrence may minimize the risk of other BV-associated complications and reduce HCRU and costs.