Cost-Effectiveness of Targeted Newborn Screening for Congenital Cytomegalovirus Infection in Japan

Speaker(s)

Tanaka M1, Saito H2, Sakai K3, Konomura K4, Suzuki M2, Tajima G5, Hoshino E5
1National Center for Child Health and Development, Setagaya, 13, Japan, 2Juntendo University, Bunkyo, Tokyo, Japan, 3Heisei Medical Welfare Group Research Institute, Shibuya, Tokyo, Japan, 4National Institute of Public Health, Wako-shi, Japan, 5National Center for Child Health and Development, Setagaya, Tokyo, Japan

Presentation Documents

OBJECTIVES: In Japan, there is an ongoing discussion about expanding the newborn screening (NBS) program to include additional diseases, with congenital cytomegalovirus (cCMV) infection being a potential candidate. Economic evaluation is crucial to justify its introduction into the NBS program. Since 2018, cCMV screening using urine samples to detect cytomegalovirus DNA has been reimbursed, and in 2023, valganciclovir was approved for treating symptomatic cCMV infection. This study aims to evaluate the cost-effectiveness of targeted newborn screening for cCMV within the Japanese healthcare system.

METHODS: A decision Markov model was developed to compare a targeted NBS program, utilizing auditory brainstem response testing followed by urine testing, against no screening. The analysis considered costs from the payer's perspective and health outcomes related to hearing loss due to cCMV infection. The incremental cost-effectiveness ratio (ICER) was simulated over 84 years with an annual discount rate of 2%. Sensitivity analyses were performed to assess the robustness of the results.

RESULTS: The base case analysis revealed an incremental cost of JPY -2,461 and an incremental effectiveness of 0.004407 quality-adjusted life years (QALYs). These results indicate that the targeted NBS program is a dominant strategy, being both less costly and more effective than no screening.

CONCLUSIONS: The introduction of a targeted NBS program for cCMV in Japan appears to improve health outcomes while reducing overall costs, suggesting it is a cost-effective approach. However, it is essential to note that this targeted screening primarily identifies hearing loss at birth using auditory brainstem response testing, potentially missing asymptomatic or non-hearing loss cCMV cases. Therefore, future research should evaluate the cost-effectiveness of universal screening to ensure comprehensive detection of all cCMV cases. Additionally, further studies may be needed to assess implementation challenges and the societal impact of expanded newborn screening for cCMV in Japan.

Code

EE125

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Infectious Disease (non-vaccine), Pediatrics