OBJECTIVE: To develop benchmark methodology for identifying gout patients and acute attacks, prevalence, patient characteristics, and rate of gout attacks from MCO data. METHODS: This retrospective study was in a 1.1 million southeastern US MCO. Patients had =2 visits with ICD-9 code for gout (274.xx) or =1 pharmacy script(s) for allopurinol, colchicine, probenecid, or sulfinpyrazone between January 1, 2000 and December 31, 2002 (intake period). Patients on allopurinol without an ICD-9 code for gout were excluded if they had neoplasm or nephrolithiasis. First gout claim/script within the intake period was the index date. Patients =18 years with continuous eligibility for one-year pre and post index date were included. Gout attack was defined as office or ER visit with medical claim for gout or joint pain (ICD-9 719.4x) and =1 of the following within seven days but not within six months prior: new pharmacy claim for NSAID, colchicine, corticosteroid, ACTH, intra-articular aspiration/injection, or microscopy of joint fluid. Statistical analysis was performed on continuous and categorical variables. RESULTS: A study cohort of 5942 gout patients was identified with prevalence rate of 1.6%. In this database, gout patients were relatively older (mean age 57±14 years), predominantly male (76%), suffered from substantial cardiovascular pre-index comorbidities (hypertension [40%], CHD [25%]), diabetes (18%), and renal impairment (5%). Nineteen percent (1121/5942) of patients had =1 gout attack. Among the gout attack subset, median rate of attacks per patient per year was 0.57 (range 0.24 to 6.9). CONCLUSION: Patients with gout were older, predominantly male, and had high rates of cardiovascular comorbidities. The prevalence rate identified is similar to other estimates in the literature. Further research is necessary to refine and validate our methodology since this work did not address self-managed gout attacks.