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Table 1 Birth/infancy, diagnosed/intervention: direct health care costs related to cCMVi at birth/infancy

From: A framework for assessing the lifetime economic burden of congenital cytomegalovirus in the United States

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

  1. 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
  2. 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 $
  3. bDirect health care cost estimates exclude out-of-pocket costs
  4. 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]
  5. 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
  6. 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
  7. 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]
  8. gLopez et al. [29] and Candrilli and Trantham [28] estimated hospitalization costs specifically related to symptomatic cCMVi
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Cost Effectiveness and Resource Allocation

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