Impact of cytomegalovirus complications on resource utilization and costs following hematopoietic stem cell transplant. (2nd January 2020)

• Record Type: Journal Article
• Authors: Schelfhout, Jonathan; Bonafede, Machaon; Cappell, Katherine; Cole, Ashley L.; Manjelievskaia, Janna; Raval, Amit D.
• Is Part Of: Current medical research and opinion. Volume 36:Number 1(2020)
• Page Start: 33
• Page End: 41
• Publication Date: 2020-01-02
• Subjects: Complications -- cytomegalovirus infection -- cytomegalovirus disease -- hematopoietic stem cell transplant -- healthcare costs -- healthcare resource utilization; Clinical medicine -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1080/03007995.2019.1664826
• Languages: English
• ISSNs: 0300-7995

Abstract

Abstract: Objective: The impact of cytomegalovirus (CMV) infection on healthcare resource utilization (HCRU) and costs post-allogeneic hematopoietic stem cell transplant (allo-HSCT) has not been well studied in the US. This retrospective, observational cohort study examined such outcomes in the first year following allo-HSCT. Methods: The IBM MarketScan administrative claims database was used to identify adults who underwent a first allo-HSCT between 1 January 2010 and 30 April 2015. Patients were required to have continuous medical and pharmacy enrollment for ≥12 months before and after the allo-HSCT. HCRU and medical costs (2016 US$) were compared by the presence or absence of CMV infection over 1-year follow-up. Results: A total of 1825 adults met the inclusion criteria (57.5% male; mean age 50.8 years). During the follow-up period, 410 (22.5%) patients had a CMV-related claim. Patients with CMV infection were significantly more likely to have a 60-day-(31.2 vs. 19.4%), 100-day-(50.0 vs. 30.5%) or 365-day readmission (78.0 vs. 57.8%) compared to those without a CMV-related event (all p < .001). During follow-up, patients with CMV infection had significantly greater mean total costs, reflecting higher inpatient costs ($677, 240 vs. $462, 562), outpatient costs ($141, 366 vs. $94, 312) and prescription drug costs ($27, 391 vs. $22, 082) (all p < .001). Valganciclovir (59.8%) and ganciclovir (33.7%) were the most commonly utilized anti-viral agents in patients with CMV. Conclusions: CMV infection was associated with significantly higher healthcare resource utilization and costs during the first year post-allo-HSCT. Additional research is warranted to further evaluate the consequences of post-HSCT CMV infection, as well as cost-effective measures to minimize its occurrence.