OBJECTIVES

: Candidiasis is one of the most common causes of vaginitis and represents a considerable burden among women with diabetes. Candida speciation and potential drug interactions drive diagnostic and treatment decsions. Our objective was to estimate the incidence and healthcare costs associated with recurrent vagnitis among women with diabetes.

METHODS

The IBM MarketScan Commercial Database was used to identify women ages 18-64 with newly diagnosed vaginitis (index date) after January 1, 2016. Women were required to have a diagnoses of Type II diabetes in the prior year. Women with a diagnosis of prior vaginitis or malignancy were excluded. Due to the fact that vaginitis typically has a short treatment course, recurrence was defined as the presence of a new vaginitis diagnosis at least 30 days post-index; sensitivty analysis was conducted using a 90-day definition. Presence of a candidiasis diagnosis was described both at index and recurrent episodes. Incidence of recurrent vaginitis (with or without candidiasis) was the primary outcome. Secondary outcomes included healthcare costs among women with type II diabetes with and without recurrent vaginitis.

RESULTS

: A total of 563,810 women met the inclusion criteria for newly diagnosed vaginitis, of which 33,880 (6.01%) had a baseline diagnosis of type II diabetes. Among these women, 22.9% had recurrent vaginitis per the 30 day definition and 18.1% ) using the 90-day criteria. Overall, a candidiasis diagnosis was present at index for 46.6% of women; a candidiasis diagnosis was present among 52.9% of women with recurrent vaginitis. Annual total healthcare costs were $20,676 and were significantly higher ($22,130 vs. $20,244, p=0.0007) for women with recurrent vaginitis.

CONCLUSIONS

: Recurrent vaginitis is common and associated with increased morbidity and annual healthcare costs. Candidiasis is often present in both initial and recurrent vaginitis, posing management challenges among women with type II diabetes.