Original article
Analysis of patient claims data to determine the prevalence of hidradenitis suppurativa in the United States

https://doi.org/10.1016/j.jaad.2012.07.027Get rights and content

Background

Recent prevalence estimates for hidradenitis suppurativa (HS), a chronic inflammatory skin condition, are limited by timeliness, population size, and generalizability.

Objective

We sought to develop prevalence estimates for HS in the United States using large health care claims databases.

Methods

A retrospective analysis used PharMetrics Integrated Database to gather health care claims information for HS among patients with 12 or more months of continuous enrollment in a commercial health care plan throughout 2007. Included patients had: 1 or more diagnoses with International Classification of Diseases, Ninth Revision, Clinical Modification code 705.83 for HS during 2007 without a Current Procedural Terminology code for HS; 1 or more Current Procedural Terminology codes of 11450, 11451, 11462, 11463, 11470, or 11471 during 2007 without International Classification of Diseases, Ninth Revision, Clinical Modification code 705.83; or both. Age- and gender-specific prevalence projections were calculated.

Results

Among included patients (n = 7927), mean age (SD) was 38.2 (14.73) years, and 5834 (74%) were women. Most patients (n = 5205; 66%) were aged 30 to 64 years. The overall prevalence estimate was 0.053% (95% confidence interval 0.051-0.054). When adjusted for gender and age, prevalence rates were 0.052% and 0.051%, respectively. The most common procedures for HS were excision of skin and subcutaneous tissue axillary/inguinal simple or intermediate repair.

Limitations

Limitations were a health insured–only population; 12-month enrollment period for 2007; HS-specific procedural codes; and possible HS misclassifications.

Conclusion

We found a low rate of clinically detected HS (0.053%; approximately 146,000-162,000 patients in the United States in 2007), with affected persons almost 3 times as likely to be female and the highest prevalence in those aged 18 to 44 years.

Section snippets

PharMetrics sample selection

In this retrospective analysis, health care claims data were gathered from the PharMetrics Integrated Database, which contains financial claims filed for reimbursement for patients enrolled in 1 of more than 90 managed care organizations or covered under employer health plans or those of family members.16 Patients who were included in the final population sample had been continuously enrolled in a health care plan the entire year of 2007. We derived 4 case definitions for HS because of the lack

Clinical and demographic characteristics of the PharMetrics HS population

Of the 15,054,519 members of the PharMetrics database with continuous enrollment across the 12 months of 2007, 7927 (0.053%) patients met at least 1 of the case definitions. The mean age (SD) was 38.2 (14.73) years, and 5834 (74%) patients were women (Table II). As shown in Table II, case definition 1 (ICD-9-CM diagnosis only) identified 7275 (92%) patients, whereas case definition 2 (CPT procedure only) contributed 101 (1%) patients. Case definition 3 (ICD-9-CM diagnosis and CPT procedure)

Discussion

This was a systematic investigation of HS in a large population in the United States. The rate of clinically detected HS was low (0.053% or an estimated total number of 146,000-162,000 patients in the United States in 2007), its affected persons were almost 3 times as likely to be female rather than male, and the prevalence was highest in those aged 18 to 44 years. The higher prevalence among women could be a result of higher use of health care19; the sex differential reported here is

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    Ms Cosmatos is currently affiliated with IMS Health Inc, Parsippany, NJ.

    Supported by Janssen Services LLC.

    Disclosure: Dr Montgomery was an employee of Janssen Services LLC, at the time of this research, and Dr Stang, Ms Cosmatos, Ms Matcho, and Dr Weinstein are or were employees of Janssen Research and Development LLC.

    Conflicts of interest: None declared.

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