OBJECTIVES : Human Papillomavirus (HPV) is the most common and second most expensive sexually transmitted infection. Most sexually active individuals acquire HPV in adolescence and early adulthood. For Germany, local data on healthcare resource utilization (HCRU) and costs for HPV-related anogenital diseases (AGD) in young women are lacking. Our prior work demonstrated the burden of AGD in young women aged 23-25 years using German statutory health insurance claims data. Using this same database, this study aimed to investigate HCRU and incremental costs of AGD in these young women.

METHODS : This retrospective claims data analysis utilizes 2012-2017 data of the “Institute for Applied Health Research Berlin” (InGef) Research Database from the birth cohorts 1989-1992. There were N=2,972 23-25 year-old women with AGD identified in the prior study (cases). These were age-matched to women without any record for AGD (controls) with a 1:10 ratio. HCRU was assessed as outpatient physician visits and inpatient hospitalizations. Associated healthcare and pharmaceutical costs were assessed and incremental costs determined. Due to data skewness, mean (M), median (Med), and Q1-Q3 range are reported.

RESULTS : Outpatient visits were higher for cases (M=52.4, Med=45.0, Q1-Q3 32.0-64.0) than controls (M=39.2, Med=33.0, Q1-Q3=21.0-50.0). 45.2% of cases and 31.7% of controls had at least one hospitalization with lengths of stay of M=19.3 and M=20.6 days, Med=6.0 and Med=5.0 days, respectively. Outpatient costs were higher in cases (M=€1,714, Med=€1,336, Q1-Q3 €907-€2,025 vs M=€1,266, Med=€940, Q1-Q3 €584-€1,538). The mean €448 incremental cost difference suggests AGD increased outpatient healthcare expenditure by €1.3 Million in the 3-year observation period for all four birth cohorts. Median inpatient costs for cases and controls were €0 (Cases M=€1,646, Q1-Q3 €0-€1,762; Controls M=€1,220, Q1-Q3 €0-€681). Cases had €214 higher mean and €30 higher median pharmaceutical costs.

CONCLUSIONS : In Germany, AGD among young women is associated with considerable resource and financial expenditure, particularly for outpatient care.