title: First estimates of the potential cost and cost saving of protecting childhood hearing from damage caused by congenital CMV infection.
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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Paediatric Immunology and Infectious Diseases, Great North Children's Hospital, Royal Victoria Hospital, Newcastle-upon-Tyne, UK Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, UK.
authors.forename: Eleri J
authors.initials: EJ
authors.lastname: Williams
authors.affiliation: Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Gray
authors.affiliation: Centre for Virology (Royal Free), University College London Medical School, London, UK Department of Paediatrics, Kingston Hospitals NHS Foundation Trust, London, UK.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Luck
authors.affiliation: Centre for Virology (Royal Free), University College London Medical School, London, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Atkinson
authors.affiliation: Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, UK.
authors.forename: Nicholas D
authors.initials: ND
authors.lastname: Embleton
authors.affiliation: Paediatric Infectious Diseases Research Group, St George's, University Hospital of London, London, UK.
authors.forename: Seilesh
authors.initials: S
authors.lastname: Kadambari
authors.affiliation: Public Health England, London, UK.
authors.forename: Adrian
authors.initials: A
authors.lastname: Davis
authors.affiliation: Centre for Virology (Royal Free), University College London Medical School, London, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Griffiths
authors.affiliation: Paediatric Infectious Diseases Research Group, St George's, University Hospital of London, London, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Sharland
authors.affiliation: Newcastle Neonatal Service, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne, UK.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Berrington
authors.affiliation: Department of Paediatric Immunology and Infectious Diseases, Great North Children's Hospital, Royal Victoria Hospital, Newcastle-upon-Tyne, UK Department of Paediatric Infectious Diseases, Lady Cilento Children's Hospital, Brisbane, Queensland Australia University of Queensland, Brisbane, Australia.
authors.forename: Julia E
authors.initials: JE
authors.lastname: Clark
mesh_terms: D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000175:diagnosis*; D004739:England; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000191:economics / Q000517:prevention & control; D006320:Hearing Tests / Q000191:economics / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000191:economics / Q000379:methods*
keywords: Audiology; Costing; General Paediatrics; Infectious Diseases; Virology