Healthcare Resource Utilization and Associated Costs of Cytomegalovirus Management among Solid Organ Transplant Recipients

W. Y. Cheng¹, P. Thompson-Leduc¹, H. Cheung¹, R. Avery², T. Bo³, S. Chavan³, M. Duh¹, I. Hirji³

¹Analysis Group, Inc., Boston, MA, ²Johns Hopkins University, Baltimore, MD, ³Shire, Cambridge, MA

Meeting: 2019 American Transplant Congress

Abstract number: D201

Keywords: Cytomeglovirus, Infection

Session Information

Session Name: Poster Session D: Non-Organ Specific: Economics & Ethics

Session Type: Poster Session

Date: Tuesday, June 4, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: Solid organ transplant (SOT) recipients who develop cytomegalovirus (CMV) infection and disease are at increased risk of morbidity. We quantified real-world healthcare resource utilization (HRU) and cost burden of CMV-treated patients among SOT recipients in the US.

*Methods: Patients ≥12 years of age were retrospectively identified from the PharMetrics Plus^TM database (2013-2016), with ≥1 SOT claim and ≥6 months of continuous enrollment before the index date, defined as first antiviral treatment date post-CMV diagnosis (treated-CMV cohort) or an imputed date (control cohort, no CMV diagnosis and no antiviral treatment). Patients were followed through December 2017 or end of continuous coverage. HRU and costs during the full follow-up and within the first year post-index (among a subgroup of patients followed ≥12 months; 1-year patient subgroup) were compared between the two cohorts using generalized linear models with inverse probability weighting.

*Results: Baseline characteristics of treated-CMV (n=899) and control (n=2,124) cohorts were well balanced after weighting. Kidney transplant recipients represented the highest proportion (51.2% [treated-CMV] and 49.0% [control]), followed by liver transplant recipients (23.4% and 24.5%). Mean follow-up was 19.6 months for treated-CMV and 14.1 months for control cohorts. HRU was higher in the treated-CMV cohort. Mean number of visits per patient per month (PPPM) were greater for the treated-CMV cohort: 5.61 versus 4.45 (incidence rate ratio [IRR]: 1.22 [95%CI: 1.11-1.34]), primarily driven by higher mean number of outpatient visits PPPM in the treated-CMV cohort: 5.12 versus 3.85 (IRR: 1.24 [95% CI: 1.13-1.37]). Similar trends were observed during the first year post-index among the 1-year patient subgroup. Treated-CMV patients incurred on average $2,182 (95%CI: $1,284-$3,145) more in healthcare costs compared with the control cohort. Cost differences among the 1-year patient subgroup were also higher among treated-CMV patients during the first year post-index by on average $3,578 (95%CI: $2,885-$4,311), largely driven by inpatient (mean difference: $1,276) and pharmacy costs (mean difference: $1,252).

*Conclusions: HRU and costs were significantly higher among SOT recipients treated for CMV compared with recipients without CMV, underscoring the substantial economic burden of CMV in SOT patients. Funding: Shire LLC

To cite this abstract in AMA style:

Cheng WY, Thompson-Leduc P, Cheung H, Avery R, Bo T, Chavan S, Duh M, Hirji I. Healthcare Resource Utilization and Associated Costs of Cytomegalovirus Management among Solid Organ Transplant Recipients [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/healthcare-resource-utilization-and-associated-costs-of-cytomegalovirus-management-among-solid-organ-transplant-recipients/. Accessed November 22, 2024.

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