Healthcare resource utilization and expenditures of women diagnosed with hypoactive sexual desire disorder

Abstract

Objective: To describe healthcare utilization and costs among commercially insured women with a diagnosis of hypoactive sexual desire disorder (HSDD) in the US and to compare them with an age-matched control cohort.

Methods: The Thomson Reuters MarketScan * Commercial Database was used to identify women aged 18-64 with an ICD-9-CM coded diagnosis of HSDD from 1/1/1998 to 9/30/2006. A control group of women with no diagnosis of any sexual dysfunction was matched 3:1 to cases based on age, health plan, and enrolment period. Healthcare utilization and costs were examined in the year prior to (pre-period) and following (post-period) index. Multivariate analyses were used to determine the adjusted difference in cost between women with and without HSDD in the post-period.

Results: In both the pre- and post-periods, women with HSDD had more outpatient office visits, radiology services, prescription medication use, and medical visits (e.g., laboratory and outpatient surgeries) relative to controls. In the 12-month post-period, women with HSDD had significantly higher total costs relative to controls ($5,504 ± 11,132 vs. $4,606 ± 12,601, p < 0.001). After adjusting for clinical characteristics, women with HSDD had total healthcare expenditures that were 16.8% higher than controls (p < 0.001).

Limitations: There is a potential for selection bias among the women who actually received a diagnosis of HSDD from a clinician. Women who received a diagnosis may be different from women without a diagnosis in ways that cannot be measured in this study. Additionally, it is possible that some women in the control group had HSDD but were undiagnosed. To the extent that the control group included women who did have HSDD, the study estimates of differences between the two groups would be underestimated.

Conclusions: Women diagnosed with HSDD use significantly more healthcare services than women without diagnosed sexual dysfunction. These higher costs are driven by a greater use of outpatient services and prescription medications.