Healthcare costs of congenital cytomegalovirus (cCMV) disease in infants during the first two years of life: a retrospective German claims database analysis

Abstract

Background Congenital cytomegalovirus (cCMV) infection can cause severe neurological damage, growth retardation, hearing loss, and microcephaly in infants. We aimed at assessing healthcare costs of infants with recorded cCMV diagnosis in an administrative claims database in the first 2 years of life. Methods We conducted a retrospective, controlled cohort study using German claims data from the Institute for Applied Health Research Berlin (InGef) database. Incremental healthcare costs during the first and second year of life were assessed by matching (1:60) infants with cCMV diagnoses ≤ 90 days after birth (cCMV90 cohort) to infants without cCMV diagnosis (“representative” controls) and infants with cCMV diagnoses ≤ 21 days after birth plus specific symptoms (cCMV21-S) to infants without cCMV and any ICD-10-GM records (besides Z00-Z99) until 4th preventive health check-up (“healthy” controls). Due to missing data, mean imputation was applied for aids and remedies costs. Results We identified 54 and 24 infants born 2014–2018 for the cCMV90 and cCMV21-S cohorts, respectively. During the first year, mean (median) healthcare costs were significantly higher in cCMV90 cases vs. “representative” controls (€22,737 (€9759) vs. €3091 (€863), p < 0.001), with 87.2% inpatient costs. Healthcare costs for cCMV21-S cases compared to “healthy” controls were €34,498 (€20,924) vs. €680 (€569), p < 0.001. Differences decreased for both comparisons in the second year but remained statistically significant. Conclusions cCMV comprises a considerable economic burden for the German healthcare system (€19,646 to €33,818 higher mean costs for infants with recorded cCMV diagnosis in the first year of life). Attempts should be made to reduce this burden.

Detecting human cytomegalovirus in urine, vagina and saliva: Impact of biological fluids and storage durations and temperatures on CMV DNA recovery

“…Human cytomegalovirus (CMV) is a leading viral cause of congenital infection and sensorineural hearing loss in children 1 . Worldwide, congenital CMV (cCMV) causes not only long‐term suffering in affected children and families, but also imposes a substantial financial burden on healthcare systems 2–4 …”

“…1 Worldwide, congenital CMV (cCMV) causes not only long-term suffering in affected children and families, but also imposes a substantial financial burden on healthcare systems. [2][3][4] To improve the understanding of the natural history of primary, nonprimary and cCMV infection, several groups have investigated CMV shedding by polymerase chain reaction (PCR) in urine, cervicovaginal secretions, saliva and breast milk of pregnant, nonpregnant and postpartum women. [5][6][7][8][9][10][11][12][13][14][15][16] These studies have provided crucial insights into not only the prevalence and kinetics of CMV shedding, which are essential to inform the development of potential preventative and therapeutic interventions, but also the possible association between CMV shedding and adverse pregnancy outcomes or cCMV.…”

Burden of sequelae and healthcare resource utilization in the first year of life in infants born with congenital cytomegalovirus (cCMV) infection in Germany: A retrospective statutory health insurance claims database analysis

“…The present work covers one part of a large retrospective study that assessed the burden of cCMV in terms of sequelae, healthcare resource utilization (HCRU) and healthcare costs in infants during the first and second year of life from the perspective of the German statutory health insurance (SHI) [17]. In this paper, we present the analysis of cCMV-associated sequelae and HCRU in infants with cCMV diagnoses compared to infants without cCMV in the first year of life (1-365 days).…”