Genital warts and cost of care in England

Abstract

Objectives: To estimate the total number of cases of, and cost of care for, genital warts (GWs) in England, to inform economic evaluations of human papillomavirus vaccination.

Methods: The number of GW cases seen in general practices (GPs) and in genitourinary medicine (GUM) clinics was estimated using the General Practice Research Database and the GUM Clinic Activity Dataset. The overlap in care of cases in the two settings was estimated. The calculated costs of care in GP and hospitals were added to the costs of care in GUM clinics (estimated elsewhere) to estimate the cost of care for GWs in England.

Results: In England, in 2008, GP and GUM saw 80,531 new (157/100,000 population) and 68,259 recurrent (133/100,000 population) episodes, giving a total of 148,790 episodes of care of GWs (289/100,000 population). Seventy-three per cent of cases were seen only in GUM clinics, 22% were seen by a GP before being referred to GUM, and 5% by GPs only. Hospital care was given in 1.3% of cases and contributed 8% of the costs. The average cost of care per episode was £113, and the estimated annual cost of care in England was £16.8 million.

Conclusions: This study provides a fairly comprehensive measure of GW frequency and care in England. GWs exert a considerable impact on health services, a large proportion of which could be prevented through immunisation using the quadrivalent human papillomavirus vaccine.

Figure 1

Estimated annual number of genital wart (GW) diagnoses and rate per 100 000 population in each setting by episode type and sex. Numbers are extrapolated to England using Office of National Statistics population data by sex, while overall numbers are age adjusted and do not equal sum of male and female patients. *Rates are per 100 000 population. GP, general practice; GUM, genitourinary medicine.

Figure 2

Estimated annual number of genital wart (GW) diagnoses per 100 000 population in England by episode type and age group.