Analysis of healthcare resource utilization before and after initiation of maribavir for cytomegalovirus treatment.

AIM: This retrospective observational cohort study aimed to assess healthcare utilization (HCRU) and costs before and after initiation of treatment with maribavir using a United States (US) administrative claims database to further the understanding of the impact of maribavir in the real world setting.

METHODS

Inovalon Databases were used to identify post-transplant patients with refractory (with or without resistant) CMV treated with maribavir between November 1, 2021 and March 31, 2024 (index = earliest treatment date). HCRU and costs were assessed during variable length periods both prior to and following initiation of maribavir. McNemar's tests were used to evaluate the statistical significance of differences for categorical variables and paired t-tests were used for continuous variables.

RESULTS

There were 230 patients eligible for analysis. Compared with the pre-maribavir phase, after the initiation of maribavir there was a significant decrease in the utilization of all-cause acute care services, including inpatient hospital admissions (54.3% v. 30.9%; p < 0.001) and emergency room visits (47.0% v. 36.5%; p = 0.014). There was a significant decrease in the number of outpatient office visits per patient per month (PPPM) (2.33 v. 1.47; p < 0.001) as well as a decrease in the number of all outpatient pharmacy prescriptions PPPM (9.64 v. 7.69; p < 0.001). Total medical costs measured PPPM prior to maribavir initiation were $9,986 compared with $5,480 (p < 0.001) after initiation of maribavir.

CONCLUSIONS

In real world practice, initiation of maribavir for the treatment of refractory or drug-resistant post-transplant CMV was associated with decreased acute care service utilization, reduced outpatient visits, and lower healthcare costs, resulting in meaningful benefits for both patients and healthcare systems. These reductions in healthcare utilization highlight maribavir's role in optimizing treatment strategies and improving the efficiency of CMV management.