Economic Burden of Diagnosed Congenital Cytomegalovirus in the United States and Japan

OBJECTIVES:

Congenital cytomegalovirus (cCMV) is the leading infectious cause of birth defects in high-income countries. We examined healthcare resource utilization (HCRU) and cost burden among cCMV patients in the US and Japan using insurance claims data.

METHODS:

This retrospective study utilized Merative™ MarketScan® Commercial Claims and Encounters and Multi-State Medicaid data (2010-2019) and Japan Medical Data Center data (2011-2020). Separately by payer population, patients were included in the cCMV cohort if their first diagnosis (index date) of cCMV (ICD-9: 771.1; ICD-10: P35.1) or CMV (ICD-9: 78.5; ICD-10: B25.x) was within 1 month of birth. The index date for non-cCMV controls was randomly selected from all claims within 1 month of birth. cCMV patients were matched 1:1 to controls on demographics, birth year, and index year. Patients were required to have ≥1 year of continuous health plan enrollment post-index (study period); all-cause HCRU and costs (2021 USD and 2020 JPY) were summarized over the 12-month study period.

RESULTS:

195 Commercial and 549 Medicaid matched pairs from the US and 152 matched pairs from Japan were included. Mean birth length of stay for US Commercial and Medicaid cases was 24 days (vs. 5 days for controls) with mean birth admission costs of $149,192 (vs. $17,996) and $49,885 (vs. $5,052), respectively. US cCMV patients had higher study period HCRU and mean costs compared to controls (Commercial: $38,742 vs. $5,519; Medicaid: $13,212 vs. $3,464). Japanese cCMV patients also had higher study period HCRU and mean costs compared to controls (¥1,652,324 vs. ¥274,652), with hospitalizations and costs highest during the first 3 months of follow-up.

CONCLUSIONS:

In the US and Japan, infants with cCMV had substantial resource burden during their first-year post-diagnosis, with 6-8 times greater incremental costs versus non-CMV controls. Future studies should continue evaluating the economic burden of diagnosed cCMV patients in countries where data are available.