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A decision model for 100 patients was developed to estimate the probabilities of cytomegalovirus infection, cytomegalovirus disease, various other complications, and death in patients receiving letermovir versus no prophylaxis. The probabilities of clinical outcomes were based on the pivotal phase 3 trial of letermovir use for cytomegalovirus prophylaxis versus placebo in adult cytomegalovirus\u2010seropositive recipients of an allo\u2010HCT. Costs of prophylaxis with letermovir and of each clinical outcome were derived from published sources or the trial clinical study reports. Incremental cost\u2010effectiveness ratios (ICERs) in terms of cost per quality\u2010adjusted life year (QALY) gained were used in the model. One\u2010way and probabilistic sensitivity analyses were conducted to explore uncertainty around the base\u2010case analysis. In this model, the use of letermovir prophylaxis would lead to an increase of QALYs (619) and direct medical cost ($1\u2009\u2009733\u2009\u2009794) compared with no prophylaxis (578 QALYs; $710\u2009\u2009300) in cytomegalovirus\u2010seropositive recipients of an allo\u2010HCT. Letermovir use for cytomegalovirus prophylaxis was a cost\u2010effective option versus no prophylaxis with base\u2010case analysis ICER $25\u2009046\/QALY gained. One\u2010way sensitivity analysis showed the most influential parameter was mortality rate. The probabilistic sensitivity analysis showed a 92% probability of letermovir producing an ICER below the commonly accepted willingness\u2010to\u2010pay threshold of $100\u2009000\/QALY gained. Based on this model, letermovir use for cytomegalovirus prophylaxis was a cost\u2010effective option in adult cytomegalovirus\u2010seropositive recipients of an allo\u2010HCT.<\/jats:p>","DOI":"10.1002\/jmv.26462","type":"journal-article","created":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T21:04:42Z","timestamp":1598475882000},"page":"3786-3794","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Cost\u2010effectiveness analysis of cytomegalovirus prophylaxis in allogeneic hematopoietic cell transplant recipients from a US payer perspective"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5139-3583","authenticated-orcid":false,"given":"Adnan","family":"Alsumali","sequence":"first","affiliation":[{"name":"Center for Observational and Real\u2010world Evidence Merck &amp; Co, Inc Kenilworth New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy F.","family":"Chemaly","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Infection Control, and Employee Health The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Graham","sequence":"additional","affiliation":[{"name":"Health Economics RTI Health Solutions, Research Triangle Park North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiling","family":"Jiang","sequence":"additional","affiliation":[{"name":"Center for Observational and Real\u2010world Evidence MSD Ltd Hoddesdon Hertfordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Merchant","sequence":"additional","affiliation":[{"name":"Center for Observational and Real\u2010world Evidence Merck &amp; 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