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First estimates of the potential cost and cost saving of protecting childhood hearing from damage caused by congenital CMV infection
  1. Eleri J Williams1,2,3,
  2. Joanne Gray4,
  3. Suzanne Luck5,6,
  4. Claire Atkinson5,
  5. Nicholas D Embleton2,3,
  6. Seilesh Kadambari7,
  7. Adrian Davis8,
  8. Paul Griffiths5,
  9. Mike Sharland7,
  10. Janet E Berrington2,3,
  11. Julia E Clark1,9,10
  1. 1Department of Paediatric Immunology and Infectious Diseases, Great North Children's Hospital, Royal Victoria Hospital, Newcastle-upon-Tyne, UK
  2. 2Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
  3. 3Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, UK
  4. 4Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
  5. 5Centre for Virology (Royal Free), University College London Medical School, London, UK
  6. 6Department of Paediatrics, Kingston Hospitals NHS Foundation Trust, London, UK
  7. 7Paediatric Infectious Diseases Research Group, St George's, University Hospital of London, London, UK
  8. 8Public Health England, London, UK
  9. 9Department of Paediatric Infectious Diseases, Lady Cilento Children's Hospital, Brisbane, Queensland Australia
  10. 10University of Queensland, Brisbane, Australia
  1. Correspondence to Dr Eleri Williams, Department of Paediatric Immunology and Infectious Diseases, Great North Children's Hospital, Royal Victoria Hospital, Newcastle-upon-Tyne NE1 4LP, UK; Eleri.Williams{at}nuth.nhs.uk

Abstract

Background Congenital cytomegalovirus (cCMV) is an important cause of childhood deafness, which is modifiable if diagnosed within the first month of life. Targeted screening of infants who do not pass their newborn hearing screening tests in England is a feasible approach to identify and treat cases to improve hearing outcome.

Aims To conduct a cost analysis of targeted screening and subsequent treatment for cCMV-related sensorineural hearing loss (SNHL) in an, otherwise, asymptomatic infant, from the perspective of the UK National Health Service (NHS).

Methods Using data from the newborn hearing screening programme (NHSP) in England and a recent study of targeted screening for cCMV using salivary swabs within the NHSP, we estimate the cost (in UK pounds (£)) to the NHS. The cost of screening (time, swabs and PCR), assessing, treating and following up cases is calculated. The cost per case of preventing hearing deterioration secondary to cCMV with targeted screening is calculated.

Results The cost of identifying, assessing and treating a case of cCMV-related SNHL through targeted cCMV screening is estimated to be £6683. The cost of improving hearing outcome for an infant with cCMV-related SNHL through targeted screening and treatment is estimated at £14 202.

Conclusions The costs of targeted screening for cCMV using salivary swabs integrated within NHSP resulted in an estimate of cost per case that compares favourably with other screening programmes. This could be used in future studies to estimate the full economic value in terms of incremental costs and incremental health benefits.

  • Costing
  • Infectious Diseases
  • Audiology
  • Virology
  • General Paediatrics

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