Objectives. To estimate the economic burden of untreated perinatal mood and anxiety disorders (PMADs) among 2017 births in the United States. Methods. We developed a mathematical model based on a cost-of-illness approach to estimate the impacts of exposure to untreated PMADs on mothers and children. Our model estimated the costs incurred by mothers and their babies born in 2017, projected from conception through the first 5 years of the birth cohort’s lives. We determined model inputs from secondary data sources and a literature review. Results. We estimated PMADs to cost $14 billion for the 2017 birth cohort from conception to 5 years postpartum. The average cost per affected mother–child dyad was about $31 800. Mothers incurred 65% of the costs; children incurred 35%. The largest costs were attributable to reduced economic productivity among affected mothers, more preterm births, and increases in other maternal health expenditures. Conclusions. The US economic burden of PMADs is high. Efforts to lower the prevalence of untreated PMADs could lead to substantial economic savings for employers, insurers, the government, and society.

Background Maternal mental health conditions (MMHCs), which include depression and anxiety disorders during pregnancy and through five years postpartum, are among the most common obstetric complications in the United States overall and in Texas in particular. In the context of potential expansion of postpartum Medicaid coverage from 60 days to one year, we sought to capture the societal, financial burden of untreated MMHCs. Methods We estimated the economic impact of untreated maternal mental health conditions (MMHCs) among births in Texas in 2019 using a cost-of-illness model. Results We found that MMHCs affected 13.2% of mothers and, when left untreated, cost $2.2 billion among mothers and children born in Texas in 2019 when following the birth cohort from conception through five years postpartum. We found that MMHCs affected 17.2% of mothers enrolled in Texas’ Medicaid for Pregnant Women and cost $962 million. In addition, the prevalence of MMHCs and resulting costs varied considerably among women of different races and ethnicities. Employers and health care payers, including Medicaid, bore most of these costs. Conclusions The Texas Health and Human Services Commission’s (HHSC) efforts to increase awareness about MMHCs and increase access to care represent an important step toward improving maternal and child health and maximizing benefits to Texas HHSC, employers, and insurers.

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Background PROVE is an ongoing international, retrospective study assessing cefiderocol (CFDC) for Gram-negative (GN) infections. Carbapenem-resistant Acinetobacter baumannii (CRAB) infections are difficult-to-treat with limited treatment options. CFDC is a novel sidero cephalosporin with activity against CRAB. This analysis describes the outcomes and treatment patterns of CFDC treatment in CRAB infections from this study. Methods Patients were eligible if they received ≥ 72 hours of CFDC. Key patient characteristics, infecting pathogen susceptibility, illness severity, and treatment patterns were assessed. Fourteen and 30-day all-cause mortality (ACM) and clinical cure were examined as outcomes. Susceptibility testing was performed locally. Serious adverse drug reactions (SADR) were recorded. Results To date,123 patients treated with CFDC at 12 sites were included. Forty-one had monomicrobial (n=29) or polymicrobial (n=12) Acinetobacter baumannii (AB) infection. All but one were CRAB. The median age was 53 years; 71% were male. The most prevalent comorbidity was severe burns (N=9, 22%). Sixty-one percent of patients received CFDC in the ICU, 51% required mechanical ventilation, and 34% required vasopressor support. The median time from positive culture to CFDC initiation was 5 days. CFDC monotherapy was used in 61%. Tetracyclines were the most common concurrent GN antibiotics used with CFDC (N = 8, 19.5%). Targeted therapy with or without prior GN antibiotics was used in 76%, salvage in 20%, and empirical in 2%. Susceptibility results were available for 28 AB cultures from 28 patients of which 82% were susceptible to CFDC. Post-CFDC 14- and 30-day ACM was 12% (95% CI: 4%-26%) and 22% (95% CI: 11%-38%), respectively. Clinical resolution was achieved in 59% (95% CI: 42% -74%). Thirty-day ACM varied by susceptibility to CFDC: 26% for susceptible, 40% for resistant. One SADR (interstitial nephritis) was reported. Cefiderocol Use Patterns in Acinetobacter baumannii Conclusion Real-world use of CFDC for AB demonstrates that most patients were complex with multiple comorbidities and severe illness prior to treatment. It was used mostly as targeted therapy. CFDC may be a treatment option in these difficult-to-treat infections. Disclosures Stephen Marcella, MD, MPH, Shionogi: Shionogi employee|Shionogi, Inc: Employee Amy L. Carr, PharmD, BCIDP, Shionogi: Advisory Board Benjamin Georgiades, PharmD, Shionogi, Inc: Employee Caroline Margiotta, MA, Shionogi, Inc: contracting work for Shionogi, Inc.