UMMS Affiliation

Department of Medicine, Division of Infectious Diseases and Immunology

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Congenital, Hereditary, and Neonatal Diseases and Abnormalities | Health Economics | Health Services Administration | Health Services Research | Virus Diseases


Background: In the United States (US), congenital cytomegalovirus infection (cCMVi) is a major cause of permanent disabilities and the most common etiology of non-genetic sensorineural hearing loss. Evaluations of prevention strategies will require estimates of the economic implications of cCMVi. We aimed to develop a conceptual framework to characterize the lifetime economic burden of cCMVi in the US and to use that framework to identify data gaps.

Methods: Direct health care, direct non-health care, indirect, and intangible costs associated with cCMVi were considered. An initial framework was constructed based on a targeted literature review, then validated and refined after consultation with experts. Published costs were identified and used to populate the framework. Data gaps were identified.

Results: The framework was constructed as a chance tree, categorizing clinical event occurrence to form patient profiles associated with distinct economic trajectories. The distribution and magnitude of costs varied by patient life stage, cCMVi diagnosis, severity of impairment, and developmental delays/disabilities. Published studies could not fully populate the framework. The literature best characterized direct health care costs associated with the birth period. Gaps existed for direct non-health care, indirect, and intangible costs, as well as health care costs associated with adult patients and those severely impaired.

Conclusions: Data gaps exist concerning the lifetime economic burden of cCMVi in the US. The conceptual framework provides the basis for a research agenda to address these gaps. Understanding the full lifetime economic burden of cCMVi would inform clinicians, researchers, and policymakers, when assessing the value of cCMVi interventions.


Burden of illness, Congenital, Cost, Cytomegalovirus, Economic, Framework, cCMV

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Copyright The Author(s). 2019. Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

DOI of Published Version



Lucas A, Sinha A, Fowler KB, Mladsi D, Barnett C, Samant S, Gibson L. A framework for assessing the lifetime economic burden of congenital cytomegalovirus in the United States. Cost Eff Resour Alloc. 2019 Oct 3;17:21. doi: 10.1186/s12962-019-0189-0. PMID: 31592087; PMCID: PMC6775673. Link to article on publisher's site

Journal/Book/Conference Title

Cost effectiveness and resource allocation : C/E

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Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.