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9/24/2018  |   10:00 AM - 10:30 AM   |  Emerald Ballroom I

The Healthcare Cost of Symptomatic Congenital CMV Infection in Privately Insured US Children: Estimates from Administrative Claims Data

Background: Published estimates of the added cost of caring for a child with congenital cytomegalovirus (cCMV) infection are sparse, with no US estimates available. In a recently published study from the Netherlands, the average medical cost through the first 6 years of life for 26 children with retrospectively-assessed symptomatic cCMV was 4.5 times higher compared to those without cCMV. Methods: We retrospectively analyzed US administrative claims data for 231,259 children with employer-sponsored health insurance who were born during 2010-2013 and followed at least 4 years. Of the entire sample, 46 (0.2 per 1000) children had diagnosis codes for cCMV or CMV in insurance claims during the first 45 days. We calculated both overall expenditures during the first 4 years of life and out-of-pocket expenditures for which families were responsible. Results: Median expenditures were $10,103 for children not coded for cCMV and $55,755 for those coded for cCMV, a ratio of 5.5 to 1. Average (mean) expenditures were $24,549 for the general cohort and $362,715 for the cCMV cohort, a ratio of 15 to 1. Expected out-of-pocket expenditures averaged $5,750 per family, compared with $2,388 for the general cohort. The additional out-of-pocket cost to cCMV families averaged $600 per year. Conclusions: Privately insured children with presumed symptomatic cCMV based on contemporary diagnoses had average 4-year cumulative expenditures 15 times greater than other children. The relative difference in average costs during the first 4-6 years was three times larger than in a recent Dutch study; we used a more restrictive definition of symptomatic cCMV. Symptomatic congenital CMV infection poses substantial costs to the US healthcare system, to employer-sponsored private health plans, and to families. The cost estimates presented here do not include the long-term costs of caring for children with serious disabilities, such as the spillover effects of caregiving demands on families.

  • To describe the overall medical costs for children with a diagnostic code for congenital CMV during their first 4 years
  • To describe out-of-payment costs for families of children with a diagnostic code for congenital CMV during their first 4 years
  • To compare costs between families with and without children with a diagnostic code for congenital CMV

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Jessica Leung (Author,Co-Author), JLeung@cdc.gov;
Jessica Leung is an epidemiologist in the Division of Viral Diseases at the Centers for Disease Control and Prevention. She works on infectious disease surveillance, outbreak investigations, and research-related projects on viral vaccine-preventable diseases in the United States. Ms. Leung received her BA in Biochemistry and Molecular Biology from Dartmouth College and MPH in Epidemiology of Microbial Diseases from Yale University.

      ASHA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Elizabeth C. Ailes (Author,Co-Author), eha0@cdc.gov;
Elizabeth Ailes is a Health Scientist in the Birth Defects Branch, Division of Congenital and Developmental Disorders at the National Center on Birth Defects and Developmental Disabilities at the U.S. Centers for Disease Control and Prevention. She joined the Branch in 2011 as an Epidemic Intelligence Service Officer. Her research focus has been on medication use among pregnant women and women of reproductive age, risk factors for birth defects, and the diagnosis of birth defects. Her previous work was in infectious disease epidemiology, including studies focused on foodborne, waterborne, and respiratory diseases. Prior to becoming an EIS officer, Elizabeth received her PhD in epidemiology from Emory University and her MPH in the epidemiology of microbial diseases from Yale University.

      ASHA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Scott D. Grosse (POC-Point of Contact,Primary Presenter), SGrosse@cdc.gov;
Scott Grosse is a health economist in the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC). He is a native of Michigan and studied economics and public health at the University of Michigan. Upon completing his doctorate in 1996, he moved his family to Atlanta for a fellowship at the CDC and never left. Dr. Grosse does research on costs and health outcomes associated with conditions that start in childhood. He has coauthored seven articles and two book chapters on congenital CMV. He also assesses the costs and benefits of public health programs such as newborn screening. In 1997 he collected and analyzed data on the costs of hospital-based newborn hearing screening in collaboration with Dr. Karl White. He has been involved with the expansion of newborn screening for a number of conditions that have evidence of improved outcomes with early diagnosis.

      ASHA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Tatiana Lanzieri (Author,Co-Author), uyk4@cdc.gov;
Tatiana Lanzieri is a medical epidemiologist in the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention.

      ASHA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial -