OBJECTIVES: Cytomegalovirus (CMV) infection occurs in approximately 60% of people in the United States (US). CMV can be transmitted from a pregnant woman to her fetus (i.e., congenital CMV [cCMV]). Roughly 20% of children with cCMV may develop permanent disability (e.g., hearing loss; developmental disabilities). While the epidemiology of cCMV has been documented, limited real-world evidence exists to quantify the associated economic burden. This study describes changes in cCMV-related hospitalizations and associated resource use (i.e., cost; length of stay [LOS]) in the US from 2004 to 2013 for infants <1 year old.
METHODS: cCMV-related hospitalizations (ICD-9-CM diagnosis code 771.1) for infants from the 2004 through 2013 HCUP Nationwide Inpatient Samples (NIS) were analyzed. Annual cCMV-related hospitalizations per 100,000 population (standardized to the 2015 US population) were estimated using NIS sampling weights and US Census data. Additionally, per-hospitalization costs (in 2016 US dollars) and LOS were assessed.
RESULTS: cCMV-related hospitalization rates among infants in the US fell 15%, from 20.9/100,000 in 2004 to 17.8/100,000 in 2013. However, during this period, mean (standard deviation [SD]) LOS increased, from 28.7 (36.2) days in 2004 to 36.7 (52.4) days in 2009, before falling to 29.1 (39.2) days in 2013. Mean (SD) costs increased from $93,683 ($138,604) in 2004 to $103,773 ($175,737) in 2013, peaking in 2011 at $128,052 ($202,961). Finally, the total burden of cCMV-related hospitalizations (i.e., aggregate costs across all cCMV-related hospitalizations) increased slightly, from $73M in 2004 to $77M in 2013, but did increase to >$80M in 2009, 2011, and 2012.
CONCLUSIONS: cCMV-related hospitalization rates among infants in the US fell during the early 2000s, but the economic burden of cCMV in this population varied appreciably during this period. Further research to understand factors which may influence the observed variability in cCMV-related hospitalization rates and costs is warranted. Such research may help plan optimal resource allocation.
