title: Utilization and cost of diagnostic methods for sexually transmitted infection screening among insured American youth, 2008.
abstract: BACKGROUND
  Private sector utilization and cost information on testing for sexually transmitted infections (STIs) in the United States is limited.
  
  
  METHODS
  We used current procedural terminology codes for tests for HIV, human papillomavirus (HPV), genital herpes simplex virus type 2, hepatitis B virus, chlamydia, gonorrhea, trichomoniasis, and syphilis. We extracted outpatient claims for persons aged 15 to 24 years in 2008 from the MarketScan database. Utilization was measured as the number of claims per 100,000 enrollees for tests specific to a given infection. We estimated claims rates and average costs by sex, compared these with Centers for Medicare and Medicaid Services (CMS) fees, and estimated the overall total cost of STI testing.
  
  
  RESULTS
  The claims rate for HPV was higher than for any other STI (P < 0.001) at 18,085/100,000, whereas that for trichomoniasis was lower than all other STIs (P < 0.001) at 517/100,000. Claims rates for females were higher than for males (P < 0.001) for all STIs. Average costs were as follows: $24 (HIV), $34 (HPV), $29 (hepatitis B virus), $25 (herpes simplex virus type 2), $43 (chlamydia), $42 (gonorrhea), $28 (trichomoniasis), and $24 (syphilis). Costs exceeded CMS fees for 67 of 78 current procedural terminologies by an average of 40%. The estimated total cost for all STIs was $403.1 million for the privately insured population aged 15 to 24 years.
  
  
  CONCLUSIONS
  We found that the utilization rates and many test costs varied by sex. Private insurers typically paid more than the CMS fee schedule for testing.
authors.affiliation: Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. Kowusuedusei@cdc.gov
authors.forename: Kwame
authors.initials: K
authors.lastname: Owusu-Edusei
authors.forename: Hang T
authors.initials: HT
authors.lastname: Nguyen
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Gift
mesh_terms: D000293:Adolescent; D017281:Cost of Illness; D005260:Female; D006069:Gonorrhea / Q000191:economics / Q000453:epidemiology; D015658:HIV Infections / Q000191:economics / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data* / Q000639:trends; D006296:Health Services / Q000706:statistics & numerical data*; D006509:Hepatitis B / Q000191:economics / Q000453:epidemiology; D006558:Herpes Genitalis / Q000191:economics / Q000453:epidemiology; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000706:statistics & numerical data; D008484:Medicaid / Q000191:economics* / Q000706:statistics & numerical data; D018803:Models, Economic; D017678:Sex Distribution; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D013587:Syphilis / Q000191:economics / Q000453:epidemiology; D014245:Trichomonas Infections / Q000191:economics / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult