National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Clin Ther. 2018 Mar;40(3):430-439.e1. doi: 10.1016/j.clinthera.2018.01.006. Epub 2018 Feb 4.
The aim of this study was to assess the clinical characteristics and trends in valganciclovir use among infants diagnosed with congenital cytomegalovirus (CMV) disease in the United States.
We analyzed data from medical claims dated 2009-2015 from the Truven Health MarketScan Commercial Claims and Encounters and Medicaid databases. We identified infants with a live birth code in the first claim who were continuously enrolled for at least 45 days. Among infants diagnosed with congenital CMV disease, identified by an ICD-9-CM or ICD-10-CM code for congenital CMV infection or CMV disease within 45 days of birth, we assessed data from claims containing codes for any CMV-associated clinical condition within the same period, and data from claims for hearing loss and/or valganciclovir within the first 180 days of life.
In the commercial and Medicaid databases, we identified 257 (2.5/10,000) and 445 (3.3/10,000) infants, respectively, diagnosed with congenital CMV disease, among whom 135 (53%) and 282 (63%) had ≥1 CMV-associated condition, 30 (12%) and 32 (7%) had hearing loss, and 41 (16%) and 78 (18%) had a claim for valganciclovir. Among infants with congenital CMV disease who had a claim for valganciclovir, 37 (90%) among commercially insured infants and 68 (87%) among Medicaid-insured infants had ≥1 CMV-associated condition and/or hearing loss. From 2009 to 2015, the percentages with a claim for valganciclovir increased from 0% to 29% among commercially insured infants and from 4% to 37% among Medicaid-insured infants (P < 0.0001).
During 2009-2015, there was a strong upward trend in valganciclovir claims among insured infants who were diagnosed with congenital CMV disease, the majority of whom had CMV-associated conditions and/or hearing loss.
本研究旨在评估美国先天性巨细胞病毒（cytomegalovirus，CMV）疾病患儿使用缬更昔洛韦的临床特征和趋势。
我们分析了 2009 年至 2015 年 Truven Health MarketScan 商业索赔和医疗保险数据库中的医疗索赔数据。我们确定了在首次索赔中有活产编码且至少连续参保 45 天的婴儿。在患有先天性 CMV 疾病的婴儿中，通过 ICD-9-CM 或 ICD-10-CM 编码在出生后 45 天内确定先天性 CMV 感染或 CMV 疾病，我们评估了同一时期内索赔中包含任何与 CMV 相关临床病症的编码数据，以及出生后 180 天内听力损失和/或缬更昔洛韦的索赔数据。
在商业和医疗保险数据库中，我们分别确定了 257（2.5/10000）和 445（3.3/10000）例患有先天性 CMV 疾病的婴儿，其中 135（53%）和 282（63%）例有≥1 例与 CMV 相关的病症，30（12%）和 32（7%）例有听力损失，41（16%）和 78（18%）例有缬更昔洛韦的索赔。在患有先天性 CMV 疾病且有缬更昔洛韦索赔的婴儿中，商业保险婴儿中有 37 例（90%）和 Medicaid 保险婴儿中有 68 例（87%）有≥1 例与 CMV 相关的病症和/或听力损失。从 2009 年到 2015 年，商业保险婴儿中缬更昔洛韦索赔的百分比从 0%增加到 29%，而 Medicaid 保险婴儿中从 4%增加到 37%（P<0.0001）。
在 2009 年至 2015 年期间，患有先天性 CMV 疾病并接受保险的婴儿中，缬更昔洛韦的使用呈明显上升趋势，其中大多数婴儿患有与 CMV 相关的病症和/或听力损失。
