Economic cost of congenital CMV in the UK

Abstract

ObjectiveCongenital cytomegalovirus (cCMV) is the most common infectious cause of congenital disability. It can disrupt neurodevelopment, causing lifelong impairments including sensorineural hearing loss and developmental delay. This study aimed, for the first time, to estimate the annual economic burden of managing cCMV and its sequelae in the UK.DesignThe study collated available secondary data to develop a static cost model.SettingThe model aimed to estimate costs of cCMV in the UK for the year 2016.PatientsIndividuals of all ages with cCMV.Main outcome measuresDirect (incurred by the public sector) and indirect (incurred personally or by society) costs associated with management of cCMV and its sequelae.ResultsThe model estimated that the total cost of cCMV to the UK in 2016 was £732 million (lower and upper estimates were between £495 and £942 million). Approximately 40% of the costs were directly incurred by the public sector, with the remaining 60% being indirect costs, including lost productivity. Long-term impairments caused by the virus had a higher financial burden than the acute management of cCMV.ConclusionsThe cost of cCMV is substantial, predominantly stemming from long-term impairments. Costs should be compared against investment in educational strategies and vaccine development programmes that aim to prevent virus transmission, as well as the value of introducing universal screening for cCMV to both increase detection of children who would benefit from treatment, and to build a more robust evidence base for future research.

Characterization of a universal screening approach for congenital CMV infection based on a highly-sensitive, quantitative, multiplex real-time PCR assay

“…Approximately 10 to 15% of them develop late-onset sequelae like sensorineural hearing loss stressing the need for a postnatal CMV screening of newborns [17,18] to allow an early diagnosis, follow up and intervention. Since screening approaches based on the occurrence of characteristic clinical manifestations at birth harbor the risk of missing asymptomatic cases, recent studies propose the implementation of a universal screening for cCMV infections [9] and show its cost-effectiveness under a wide range of assumptions [2,[18][19][20]. However, since the majority of cCMV infected children that are asymptomatic at birth never develop clinical symptoms, there is also a need to limit the number of parents that are unnecessarily worried by their children getting diagnosed as having a cCMV infection.…”

Congenital Cytomegalovirus Infection: A Narrative Review of the Issues in Screening and Management From a Panel of European Experts

“…Finally, further evidence of cost-effectiveness is required. Whilst the cost-effectiveness of universal and targeted newborn cCMV screening programs has been assessed in the UK and USA (46,47), and the economic burden of cCMV in the UK estimated (82), currently there are insufficient cost-benefit data, which hinders the implementation of screening.…”

Universal Screening for Congenital CMV Infection

“…Acute management of cCMV was the lowest contributing cost (estimated at £1.2 million), with costs for management of longterm sequelae being orders of magnitude greater. As well as in the United States, also in the United Kingdom, both universal and targeted newborn screening would be cost-effective options for detecting and reducing hearing loss and other consequences caused by cCMV [32].…”