OBJECTIVES: SCD is an inherited disorder characterized by lifelong morbidity and reduced life expectancy. Treatments include blood transfusion, pain medication and hydroxyurea (HU). We analyzed treatments, outcomes and costs in outpatient setting. METHODS: 9,281 patients were identified from the 2000-2004 Pharmetrics® Database using ICD-9 Codes (282.41, 282.42, 282.6x). Crisis was defined either by a diagnosis code referring to crisis (282.42, 282.62,282.64,282.69), strong opioid use, ER admission or SCD hospitalization. RESULTS: 44% of patients were younger than 16 yrs; 56% were female. Mean age was 22(±19). Seventy-seven percent had one or more painful crises in one year. In the HbSS subtype, 85% had at least one crisis. Incidence and frequency of painful crises increased by age: 70%(0-6 yrs); 75%(6-16) and 82%( >16) and 1.0/yr, 2.4/yr and 4.7/yr, respectively. Two-thirds of adults with Hb SS who experienced crisis received opioids compared to 22% of children, aged 0-6 with Hb SS and crisis . Thirty-seven percent had at least one ER visit; in adult Hb SS patients more than 50%. Average annual hospitalization rate was 32.4%, with 2.25 admissions and length of stay 6 days. Hb SS patients had a hospitalization rate >40%. Patients with crisis were four times as likely as non-crisis patients to require multiple hospitalizations. Overall annual stroke rate was 3.9%; in adult HbSS patients it was 7.2%. Hb SS children had rates of 1.13% (<6yr) and 4.22% (6-16 yr). Annual costs, including hospitalization costs, ranged from $1,140 in <6yrs without crisis to $20,432 in adults with crisis. Health cost in crisis patients were 5-fold that of non-crisis patients. CONCLUSION: SCD has major impact on patients' outcomes such as pain, stroke and costs thousands of dollars per patient/year. The incidence of crises correlates with health care resource utilisation and cost. Treatments that avoid crises will have positive impact on quality of life and costs.