Healthcare resource utilization and costs associated with a diagnosis of infectious mononucleosis in children, adolescents, and adults in the United States

OBJECTIVE: Epstein-Barr virus (EBV) is responsible for 90% of infectious mononucleosis (IM) cases. Clinically, IM often presents with fever, fatigue, sore throat, and lymphadenopathy, but can also result in prolonged symptoms requiring hospitalization. As little is known about the impact of IM on healthcare resource utilization (HCRU) and costs in the US general population, we evaluated these outcomes following IM diagnosis in non-transplant children, adolescents, and adults. METHODS: A retrospective analysis was conducted using Merative MarketScan Commercial Claims and Encounters and Multi-State Medicaid databases. Since the COVID-19 pandemic had a substantial impact on patterns of HCRU, separate pre-pandemic and pandemic time periods were analyzed. Non-transplant individuals aged 5-40 years with diagnosed IM were selected and matched 1:1 to controls. RESULTS: For the pre-pandemic (pandemic) periods, 31,671 (17,341) commercial and 10,758 (6,597) Medicaid matched pairs were included. All-cause HCRU and costs during the 6-month follow-up were generally higher for diagnosed IM cases vs controls. Significantly greater mean total medical visits and outpatient visits, as well as significantly higher percentages of hospitalizations, were observed for commercially-insured and Medicaid-enrolled IM cases vs controls across both time periods. Median total medical costs were significantly higher for IM cases than controls for commercially-insured ($1,050 vs $516; $1,346 vs $570) and Medicaid-enrolled ($701 vs $419; $938 vs $537) cohorts during the pre-pandemic and pandemic periods, respectively. CONCLUSION: In broad population-based US cohorts, individuals with diagnosed IM had significantly higher HCRU and healthcare costs than matched controls. Preventative strategies, such as vaccination against EBV and/or IM, could help reduce disease burden.