Estimating the incidence and prevalence of juvenile-onset recurrent respiratory papillomatosis in publicly and privately insured claims databases in the United States.
BACKGROUND
Juvenile-onset recurrent respiratory papillomatosis (JORRP) is a chronic disease caused by human papillomavirus types 6 and 11. It is associated with significant morbidity that places intense physical, psychological, and financial strain on patients and their families. Few studies have assessed the incidence and prevalence of JORRP in the United States.


METHODS
This retrospective, longitudinal cohort study was performed using data from a pair of large insurance claims databases in the United States. The Optum Clinformatics and Truven MarketScan Medicaid databases represent a sample of privately and publicly insured children, respectively. Cohorts of children aged 0 to 17 years were created within each database to estimate the incidence and prevalence of JORRP in 2006. Claims-based algorithms were designed to capture as many potential cases as possible. To improve the accuracy of the incidence and prevalence estimates, chart validation was performed to estimate the positive predictive value (PPV) of the claims-based algorithms.


RESULTS
The overall PPV-adjusted incidence of JORRP in 2006 was 0.51 per 100,000 in Optum and 1.03 per 100,000 in the MarketScan Medicaid population. Peak incidence was observed among 0- to 4-year-olds in both databases. The PPV-adjusted prevalence of JORRP in 2006 was 1.45 and 2.93 per 100,000 in the Optum and MarketScan Medicaid cohorts, respectively.


CONCLUSIONS
Although relatively uncommon, JORRP represents a disease with significant morbidity. The incidence and prevalence of JORRP in publicly insured children were consistently higher than those covered by private insurance plans, suggesting an increased burden of illness among those with lower socioeconomic status.
From the *Epidemiology Department, Merck Research Laboratories, North Wales, PA; †OptumInsight, Eden Prairie, MN; and ‡Department of Otolaryngology, Pediatric Otolaryngology, Eastern Virginia Medical School Children's Hospital of the King's Daughters, Norfolk, VA.
Mark
M
Marsico
Vinay
V
Mehta
Benjamin
B
Chastek
Kai-Li
KL
Liaw
Craig
C
Derkay
D000293:Adolescent; D017668:Age of Onset; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D052140:Human papillomavirus 11 / Q000276:immunology*; D052163:Human papillomavirus 6 / Q000276:immunology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data*; D008297:Male; D030361:Papillomavirus Infections / Q000191:economics / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000191:economics; D015995:Prevalence; D011634:Public Health; D015203:Reproducibility of Results; D012141:Respiratory Tract Infections / Q000191:economics / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
D053918:Papillomavirus Vaccines