Table 1.
Birth/infancy, diagnosed/intervention: direct health care costs related to cCMVi at birth/infancy
| Cost component | Cost estimatea,b | Cost estimate (uncertainty) | Population | Data source | Source |
|---|---|---|---|---|---|
| cCMVi-related total direct health care costs per patient | |||||
| Birth to < 1 year | Mean: $61,056 | SD: $177,404 | At least one medical claim with a corresponding diagnosis (i.e., ICD-9-CM code 771.1 or 078.5; ICD-10-CM code P35.1 or B25) and < 1 year of age on the first observed claim for cCMVi | MarketScan CCAE and Medicaid databases | Meyers et al. [27] |
| Cost per hospitalization | |||||
| Birth only | Geo mean: $96,283 | SE: $10,507 | In-hospital birth with an ICD-9-CM code of 771.1 in any diagnoses listed in the database and symptomatic diseasec | KID | Inagaki et al. [26]d |
|
Mean, vaginal: $25,203 Mean, caesarian: $32,986 |
SD, vaginal: $96,443 SD, caesarian: $174,303 |
ICD-9-CM codes 771.1 or 078.5 or ICD-10-CM code P35.1 or B25 during birth-associated inpatient stay | MarketScan CCAE and Medicaid databases | Meyers et al. [27]e | |
| < 1 year (including birth) |
Mean, < 1 year of age: $77,538 Mean, < 1 month of age: $93,371 |
SD, < 1 year of age: $5938 SD, < 1 month of age: $8732 |
Hospitalization in an infant < 1 year of age with an ICD-9-CM code for cCMVi (771.1), excluding those with codes for HIV (042) or transplant-related diagnoses (transplant [V42], transplant complication [996.8], transplant operation [E87.80]) and a cCMV-related conditionf | KID | Lopez et al. [29]g |
| Mean: $107,744 | SD: $182,461 | A diagnosis of cCMVi (ICD-9-CM code 771.1) and < 1 year of age at admission | KID | Candrilli and Trantham [28]g | |
CCAE, Commercial Claims and Encounters; cCMVi, congenital cytomegalovirus infection; CPI, Consumer Price Index; geo, geometric; HIV, human immunodeficiency virus; ICD-9-CM, International Classification of Diseases, 9th Revision, Clinical Modification; ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification; KID, Kids’ Inpatient Database; SD, standard deviation; SE, standard error; US, United States
aCost estimates are inflated to 2018 US $ using the medical care component of the CPI [31]. Meyers et al. and Candrilli and Trantham [28] were originally presented in 2016 US $. Lopez et al. [29], and Inagaki et al. [26] were originally presented in 2012 US $
bDirect health care cost estimates exclude out-of-pocket costs
cInagaki et al. [26] defined symptomatic cCMV disease as “cases with cCMV accompanied by one or more of the following ICD-9-CM codes (codes are diagnosis codes unless specified otherwise): thrombocytopenia (287.3, 287.4, 287.5, 776.1) or requirement for platelet transfusion (procedure code 99.05), petechiae (287.2, 72.6,782.7), hepatomegaly (789.1), splenomegaly (289.51, 789.2), intrauterine growth restriction (764), hepatitis (070.9, 571.4, 571.8, 571.9, 573.1, 573.2, 573.3, 774.4), microcephaly (742.1) or other central nervous system involvement (331.3, 331.4, 742.2, 742.3, 742.4, 779.7), hearing loss (389.1, 389.2, 389.7, 389.8, 389.9, 794.15), or chorioretinitis (363.0, 363.1, 363.20).” [p2]
dInagaki et al. [26] reported the geometric mean of total charges for patients with and without symptomatic cCMV disease. The cCMVi-related cost estimate was calculated as the difference between these two means
eKnowledge of a cCMVi diagnosis may affect the choice of delivery. Meyers et al. [27] did not report whether the mother had knowledge of a cCMVi diagnosis before labor. Meyers et al. [27] also reported the difference of mean costs between patients with and without cCMV disease. The population characteristics in the above table were used to define cCMV disease
fAccording to Lopez et al. [29], “Symptomatic cCMV-related conditions were defined using International Classification of Diseases, 9th Revision, codes as follows: microcephaly (742.1), hepatomegaly (789.1, 573.1), splenomegaly (789.2), thrombocytopenia (776.1, 287.3, 287.4, 287.5, 776.2), seizures (345, 779.0, 780.39), encephalitis (323, 058), other neurological symptoms (742), cerebral palsy (343), petechiae (772.6, 782.7), hearing loss (389, 315.34, 388.2) and chorioretinitis (363.0, 363.1, 363.2, 363.3).” [p2]
gLopez et al. [29] and Candrilli and Trantham [28] estimated hospitalization costs specifically related to symptomatic cCMVi