{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:13:57Z","timestamp":1792782837730,"version":"4.5.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum K\u00f6ln","id":[{"id":"https:\/\/ror.org\/05mxhda18","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Health Econ"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Letermovir has demonstrated efficacy and tolerability as prophylaxis against clinically significant cytomegalovirus infection (csCMVi) in CMV-seropositive adult patients undergoing allogeneic hematopoietic cell transplantation (alloHCT) compared to alternative antivirals. Despite these advantages, associated costs remain substantial. This study addresses the evidence gap by evaluating the health economic impact of CMV prophylaxis with letermovir in a real-world setting for alloHCT patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, multi-centre case-control study was conducted at six German tertiary care centres. A micro-costing approach evaluated hospitalisation and anti-CMV drug acquisition costs over a 48-week follow-up period post-alloHCT. The analysis included patients surviving at least 100 days following alloHCT, comparing individuals receiving letermovir prophylaxis (cases) with those who did not (controls) between January 2018 and April 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The incidence of csCMVi was significantly higher in the control than in the letermovir group (56%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200998 vs. 34%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200963,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Median hospital length of stay was significantly longer in the control group (45 days, IQR 36\u201366) compared to the letermovir group (39 days, IQR 32\u201355;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Hospitalisation costs were comparable (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.865), while anti-CMV drug acquisition and overall direct treatment costs were significantly higher in the letermovir group (\u20ac21,844, 95% CI 19,247\u2009\u2212\u200925,107 vs. \u20ac7,711, 95% CI 12,692\u2009\u2212\u200925,107,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; 81,871, 95% CI 76,721\u2009\u2212\u200987,021 vs. 67,161, 95% CI 61,693\u2009\u2212\u200972,629,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Besides letermovir, cost drivers post-alloHCT were rehospitalisation and csCMVi.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study demonstrated higher anti-CMV drug acquisition costs and overall direct treatment costs in patients receiving letermovir prophylaxis compared to controls. However, these higher costs are accompanied by significantly improved clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10198-025-01890-4","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T01:18:51Z","timestamp":1771204731000},"page":"1469-1478","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Healthcare resource utilization and costs of letermovir for cytomegalovirus-prophylaxis after allogeneic hematopoietic cell transplantation in a real-world, multi-centre study in Germany"],"prefix":"10.1007","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8450-7467","authenticated-orcid":false,"given":"Marie","family":"Engelhard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian M.","family":"Wingen-Heimann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika Y.","family":"Classen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor-Wolfgang","family":"Blau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gesine","family":"Bug","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinna","family":"Hebermehl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Kraus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Penack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s R.","family":"Rettig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timo","family":"Schmitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Steinbrunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Teschner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria J. 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Where necessary, participating study sites received their local ethics votes at the respective ethics commissions.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Since documentation was retrospective and anonymized, no signed consent was required from individual patients.","order":2,"name":"Ethics","label":"Consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"ME received travel grants from Tillotts. SMWH has received research and travel grants from Astellas, MSD, and Tillotts; research grants from Basilea, Gilead, and 3\u00a0M; travel grants from Pfizer, and lecture honoraria from Astellas, MSD, and Tillotts. IWB participated on an advisory board on infection disease treatment in haematology patients by MSD. GB has received research grants from Novartis, honoraria from BMS, Gilead, Jazz, Novartis, Otsuka, and travel grants from Gilead and Jazz. SK has received speaker or consulting fees from BMS, Jazz Pharmaceuticals, Novartis Pharma GmbH, AstraZeneca, Janssen Pharmaceutica, GSK, Pentixapharm. OP has no conflicts of interest directly related to this work. OP has received honoraria or travel support from Gilead, Jazz, MSD, Neovii, Novartis, Pfizer and Therakos. He has received research support from Incyte and Priothera. He is member of advisory boards to Equillium Bio, Jazz, Gilead, Novartis, MSD, Omeros, Priothera, Sanofi, Shionogi and SOBI. OP acknowledges the support of Jos\u00e9 Carreras Leuk\u00e4mie-Stiftung (3R\/2019, 23R\/2021), Deutsche Krebshilfe (70113519), Deutsche Forschungsgemeinschaft (PE 1450\/7\u2009\u2212\u20091, PE 1450\/9\u2009\u2212\u20091, PE 1450\/10\u2009\u2212\u20091) and Stiftung Charit\u00e9 BIH (BIH_PRO_549, Focus Group Vascular Biomedicine). ARR has received grants from DFG Walter Benjamin-Stipendium, unrelated to this work (no support for the present manuscript). DT has received research grants from Gilead Sciences, speaker or consulting fees from Abbvie, AstraZeneca, Gilead, Jazz, MSD, Noscendo, Novartis, Octapharma, Pfizer, Sanofi, Takeda, & Tillotts, and travel support from Abbvie, Gilead, Jazz, Medac, & Tillotts. MJGTV has received research grants from 3\u00a0M, Astellas Pharma, Biontech, DaVolterra, Evonik, Gilead Sciences, Glycom, Immunic, MaaT Pharma, MSD, Organobalance, Seres Therapeutics, Takeda Pharmaceutical and speaker or consulting fees from Astellas Pharma, Basilea, Bio-M\u00e9rieux, DaVolterra, Farmak International Holding GmbH, Ferring, Gilead Sciences, Immunic AG, MaaT Pharma, MSD, Pfizer, Roche, Organobalance, SocraTec R&D GmbH. SK has received speaker or consulting fees from BMS, Jazz Pharmaceuticals, Novartis Pharma GmbH, AstraZeneca, Janssen Pharmaceutica, GSK, Pentixapharm. CW has received consulting fees or travel support from Takeda, mundipharma and Jazz Pharmaceuticals and has received a research grant from Takeda. JJV received research grants from MSD, Gilead, Pfizer, Astellas Pharma, Basilea, German Centre for Infection Research (DZIF), German Federal Ministry of Education and Research (BMBF), Deutsches Zentrum f\u00fcr Luft- und Raumfahrt (DLR), University of Bristol, Rigshospitalet Copenhagen, German Network University Medicine, German Cancer Consortium (DKTK), German Federal Ministry of Health (BMG), European Union, speaker fees from MSD, Gilead, Pfizer, Astellas Pharma, Basilea, German Centre for Infection Research (DZIF), University Hospital Freiburg\/Congress and Communication, Academy for Infectious Medicine, University Manchester, German Society for Infectious Diseases (DGI), \u00c4rztekammer Nordrhein, \u00c4rztekammer Hessen, University Hospital Aachen, Back Bay Strategies, German Society for Internal Medicine (DGIM), Shionogi, Molecular Health, Netzwerk Universit\u00e4tsmedizin, Janssen, NordForsk, Biontech, APOGEPHA, German Cancer Consortium (DKTK), University Hospital Oldenburg, and meeting and travel support from German Centre for Infection Research (DZIF), University Manchester, German Society for Infectious Diseases (DGI), University Hospital Aachen, German Society for Internal Medicine (DGIM), Netzwerk Universit\u00e4tsmedizin, German Cancer Consortium (DKTK). SMP received travel grants and lecture honoraria from Tillotts. AYC, CH, TSc, and TSt have no conflicts of interest.","order":3,"name":"Ethics","label":"Competing interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}