title: Medical resource use and costs related to central precocious puberty: a retrospective cohort study.
abstract: OBJECTIVE
  To evaluate the economic burden of central precocious puberty (CPP) by examining direct health care resource utilization and costs.
  
  
  METHODS
  Administrative claims from the Medstat MarketScan Commercial Claims database were analyzed, and 2 cohorts of children ≤ 12 years of age were identified. The CPP cohort included patients newly diagnosed with precocious sexual development and puberty (International Classification of Diseases, Ninth Revision, Clinical Modification code 259.1x) between January 1, 2004, and June 30, 2006 (date of the initial diagnosis of CPP was designated as the "index date") who used gonadotropin-releasing hormone agonists during the 12 months after diagnosis. Each patient with CPP was matched with 4 control patients without CPP on the basis of age, sex, geographic region, and type of health insurance plan. Resource utilization and costs during the 12 months before and the 12 months after the index date were examined.
  
  
  RESULTS
  A total of 172 patients with CPP and 688 control patients were identified after matching. Approximately 62% of patients were 7 to 9 years of age, and 87% were female. The patients with CPP had higher annual health care costs than did the control patients during the 12-month pre-index ($10,968 versus $783; P<.001) and the 12-month post-index ($21,071 versus $849; P<.001) periods, primarily attributable to outpatient and pharmacy costs. For the patients with CPP, annual health care costs increased by $10,103 after diagnosis. On average, annual CPP-related costs were $10,605. Monthly total health care costs for the patients with CPP increased sharply during the first month after diagnosis and remained high throughout the post-index period.
  
  
  CONCLUSIONS
  In this study, health care resource use and costs among patients with CPP were substantial before and after the initial diagnosis of CPP.
authors.affiliation: United BioSource Corporation, Lexington, Massachusetts 02420, USA.
authors.forename: Shih-Yin
authors.initials: SY
authors.lastname: Chen
authors.forename: Mahesh
authors.initials: M
authors.lastname: Fuldeore
authors.forename: Luke
authors.initials: L
authors.lastname: Boulanger
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Fraser
authors.forename: Kristof
authors.initials: K
authors.lastname: Chwalisz
authors.forename: Steven E
authors.initials: SE
authors.lastname: Marx
mesh_terms: D000553:Ambulatory Care / Q000191:economics* / Q000706:statistics & numerical data; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D016527:Drug Costs; D005260:Female; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000031:analogs & derivatives / Q000191:economics / Q000627:therapeutic use; D017048:Health Care Costs; D006801:Humans; D007223:Infant; D007349:Insurance, Health, Reimbursement; D008297:Male; D010593:Pharmaceutical Services / Q000191:economics* / Q000706:statistics & numerical data; D011629:Puberty, Precocious / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D007987:Gonadotropin-Releasing Hormone