HEALTHCARE RESOURCE UTILIZATION AND COSTS ASSOCIATED WITH NEUTROPENIA/LEUKOPENIA-RELATED HOSPITALIZATIONS IN KIDNEY TRANSPLANT RECIPIENTS RECEIVING VALGANCICLOVIR PROPHYLAXIS IN GERMANY: A CLAIMS DATABASE STUDY
Author(s)
Mina Bachtiari, MSc1, Vanessa Colonna, PhD1, Nadine Walz, B.A.1, Kathrin Gerchow, MPH2, Kim-Sarah Krinke, PhD3, Oliver Witzke, PhD4, Klemens Budde, PhD5.
1MSD Sharp & Dohme GmbH, München, Germany, 2Cencora, Hannover, Germany, 3Cencora, Hanover, Germany, 4Director Department of Infectious Diseases and Nephrology, West German Centre of Infectious Diseases, University Hospital Essen, Essen, Germany, 5Charité Universitätsmedizin Berlin, Berlin, Germany.
1MSD Sharp & Dohme GmbH, München, Germany, 2Cencora, Hannover, Germany, 3Cencora, Hanover, Germany, 4Director Department of Infectious Diseases and Nephrology, West German Centre of Infectious Diseases, University Hospital Essen, Essen, Germany, 5Charité Universitätsmedizin Berlin, Berlin, Germany.
OBJECTIVES: Cytomegalovirus (CMV) remains a major postoperative complication in solid organ transplantation, contributing to increased mortality, morbidity, and long-term complications. Valganciclovir is recommended in German and international guidelines for CMV prophylaxis of seronegative recipients of seropositive donor organs. However, its use is often associated with hematological toxicities such as leukopenia and neutropenia (L/N). The aim of the study was to assess the clinical and economic burden associated with L/N related hospitalizations in kidney transplant recipients receiving valganciclovir prophylaxis in Germany.
METHODS: A retrospective analysis utilizing statutory health insurance claims from the InGef research database was performed. Eligible individuals were aged ≥12 years, had undergone kidney transplantation between 2015-2022, received ≥1 valganciclovir prescription for CMV prophylaxis within 40 days after discharge from the transplant hospitalization, were continuously observable for ≥365 days follow-up, and were not treated with letermovir during observation. A direct 1:1 matching approach based on age, sex, and Charlson Comorbidity Index (CCI) was employed to compare patients experiencing L/N-related hospitalizations vs all-cause hospitalizations. Healthcare resource utilization and associated costs were evaluated for 365 days of follow-up.
RESULTS: Among 705 evaluable kidney transplant cases, 80 had L/N-related hospitalizations and 597 had all-cause hospitalizations in the follow-up period. After matching, 70 cases per group were retained with a mean age of 54.7 vs 54.4 years, 61.4% males, and a mean CCI of 4.6. During follow-up, patients with L/N-related hospitalizations exhibited significantly more mean all-cause hospitalizations (7.0 vs 5.0), prolonged inpatient stays (56.1 vs 25.8 days), and elevated mean total healthcare expenditures (€59,321 vs €37,298), especially for inpatient care (€26,723 vs €10,647) and pharmaceuticals (€27,874 vs €21,522).
CONCLUSIONS: These results reveal that patients with hospitalizations driven by hematological complications constitute a vulnerable subgroup among renal allograft recipients, placing a significant burden on both the patients themselves and on the healthcare system.
METHODS: A retrospective analysis utilizing statutory health insurance claims from the InGef research database was performed. Eligible individuals were aged ≥12 years, had undergone kidney transplantation between 2015-2022, received ≥1 valganciclovir prescription for CMV prophylaxis within 40 days after discharge from the transplant hospitalization, were continuously observable for ≥365 days follow-up, and were not treated with letermovir during observation. A direct 1:1 matching approach based on age, sex, and Charlson Comorbidity Index (CCI) was employed to compare patients experiencing L/N-related hospitalizations vs all-cause hospitalizations. Healthcare resource utilization and associated costs were evaluated for 365 days of follow-up.
RESULTS: Among 705 evaluable kidney transplant cases, 80 had L/N-related hospitalizations and 597 had all-cause hospitalizations in the follow-up period. After matching, 70 cases per group were retained with a mean age of 54.7 vs 54.4 years, 61.4% males, and a mean CCI of 4.6. During follow-up, patients with L/N-related hospitalizations exhibited significantly more mean all-cause hospitalizations (7.0 vs 5.0), prolonged inpatient stays (56.1 vs 25.8 days), and elevated mean total healthcare expenditures (€59,321 vs €37,298), especially for inpatient care (€26,723 vs €10,647) and pharmaceuticals (€27,874 vs €21,522).
CONCLUSIONS: These results reveal that patients with hospitalizations driven by hematological complications constitute a vulnerable subgroup among renal allograft recipients, placing a significant burden on both the patients themselves and on the healthcare system.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE40
Topic
Economic Evaluation, Real World Data & Information Systems, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine), Surgery