OBJECTIVE: To estimate health care (HC) resource utilization and costs associated with congenital cytomegalovirus disease (cCMV) at birth and in the first year of life in the United States.
METHODS: This retrospective analysis used insurance claims data from the MarketScan Commercial Claims and Encounters and Multi-State Medicaid databases between January 1, 2011, and December 31, 2016. Infants with a cCMV diagnosis (ICD-9-CM codes 771.1, 078.5; ICD-10-CM codes P35.1, B25) were included. Claims were categorized as for the initial hospital stay at birth (“birth” analysis) or occurring in the subsequent 12 months, excluding birth (“post-birth” analysis). Infants with cCMV in both analyses were matched 1:1 to infants without cCMV based on demographic and clinical characteristics. All-cause costs were compared between infants with cCMV and matched controls. Multivariable regression analyses were conducted to control for additional confounding factors.
RESULTS: In total, 397 cCMV patients (167 vaginal delivery, 230 caesarean delivery) were identified for the “birth” analysis and matched to controls. At birth, cCMV patients had an additional 9.1 (95% confidence interval [CI]: 5.8 to 12.3) and 9.0 (95% CI: 4.6 to 13.5) inpatient days and $24,274 (95% CI: $10,082 to $38,466) and $31,770 (95% CI:$9,911 to $53,630) more inpatient costs versus controls, for vaginal and caesarean delivery, respectively. Post-birth, 678/679 of identified cCMV patients were matched with 678 controls. Post-birth, cCMV patients had an additional $58,806 (95% CI: $41,247 to $76,365) in costs versus controls, with inpatient visits accounting for 85% of the average difference. cCMV patients accrued HC costs at birth averaging 1.5 to 2.1 times greater than controls for caesarean and vaginal delivery, respectively. During the first year of life, cCMV patients had costs averaging 7 times greater than matched controls.
CONCLUSIONS: cCMV is associated with substantial economic burden at birth and throughout the first year of life.
