OBJECTIVES: Interstitial Cystitis (IC) is a debilitating condition that affects up to five percent of the United States (US) population (Clemens, 2015). The condition is characterized by bladder pain, urinary urgency and frequency, and in some patients, bladder lesions called Hunner’s Lesions (HL). Patients with HL experience a clinical course distinct from patients without HL. Prior research describing the burden of IC is outdated and lacks HL-level detail. This study aims to characterize healthcare utilization, direct costs, and comorbidities associated with IC, as well as elucidate differences between IC with and without HL. METHODS: A retrospective analysis was conducted using healthcare claims from the Truven MarketScan® Research Databases. Adults with incident IC diagnosis between 2009 and 2014 were identified and matched to controls on age, gender, and geographic region. Healthcare utilization, direct costs, and comorbidities during the first 12 months after diagnosis were compared between the two cohorts, as well as between IC subgroups with and without HL. RESULTS: IC patients (n=24,836) were predominantly (92%) female, with a mean age of 49.0 years.  IC patients utilized significantly more healthcare resources across all categories compared to non-IC patients. On average, total healthcare costs were more than twice as high among patients with IC compared to non-IC patients ($14,824 vs $6,984; p<0.001), with outpatient costs contributing the most to this difference ($9,160 vs $3,878; p<0.001). IC patients were significantly more likely than non-IC patients to develop comorbidities, with anxiety being the most common (11% vs 4%; p<0.001). Among IC patients, the HL subgroup (n=292) utilized significantly more healthcare resources across all categories and incurred significantly higher total healthcare costs compared to the non-HL subgroup ($21,371 vs $14,746; p<0.001). CONCLUSIONS: Our findings suggest that IC is associated with significant healthcare utilization, costs, and comorbidities, which are further amplified in those with HL.