Cost-effectiveness of rotavirus vaccination in Albania

Ahmeti, Albana; Preza, Iria; Simaku, Artan; Nelaj, Erida; Clark, Andrew; García, Ana Gabriela Félix; Lara, Carlos; Hoestlandt, Céline; Blau, Julia J. C.; Bino, Silvia

doi:10.1016/j.vaccine.2014.12.075

Cited by 15 publications

(6 citation statements)

References 16 publications

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“…The model is designed to be used at the country-level to conduct cost-effectiveness analyses for three vaccines: Rotavirus vaccine, Pneumococcal conjugate vaccine, and Haemophilus influenza type b and provides a consistent and transparent framework for comparing the impact and cost-effectiveness of these vaccines [10]. The model has been widely used across the world to evaluate the cost-effectiveness of these vaccines [11], [12], [13], [14], [15], [16]. The model input parameters include: demographics, burden of disease, vaccine schedule, vaccine efficacy, vaccine coverage, vaccine costs, health service utilization, and health service costs.…”

Section: Methodsmentioning

confidence: 99%

Impact and cost-effectiveness of rotavirus vaccination in Bangladesh

Pecenka

Parashar

Tate

et al. 2017

Vaccine

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IntroductionDiarrheal disease is a leading cause of child mortality globally, and rotavirus is responsible for more than a third of those deaths. Despite substantial decreases, the number of rotavirus deaths in children under five was 215,000 per year in 2013. Of these deaths, approximately 41% occurred in Asia and 3% of those in Bangladesh. While Bangladesh has yet to introduce rotavirus vaccination, the country applied for Gavi support and plans to introduce it in 2018. This analysis evaluates the impact and cost-effectiveness of rotavirus vaccination in Bangladesh and provides estimates of the costs of the vaccination program to help inform decision-makers and international partners.MethodsThis analysis used Pan American Health Organization’s TRIVAC model (version 2.0) to examine nationwide introduction of two-dose rotavirus vaccination in 2017, compared to no vaccination. Three mortality scenarios (low, high, and midpoint) were assessed. Benefits and costs were examined from the societal perspective over ten successive birth cohorts with a 3% discount rate. Model inputs were locally acquired and complemented by internationally validated estimates.ResultsOver ten years, rotavirus vaccination would prevent 4000 deaths, nearly 500,000 hospitalizations and 3 million outpatient visits in the base scenario. With a Gavi subsidy, cost/disability adjusted life year (DALY) ratios ranged from $58/DALY to $142/DALY averted. Without a Gavi subsidy and a vaccine price of $2.19 per dose, cost/DALY ratios ranged from $615/DALY to $1514/DALY averted.ConclusionThe discounted cost per DALY averted was less than the GDP per capita for nearly all scenarios considered, indicating that a routine rotavirus vaccination program is highly likely to be cost-effective. Even in a low mortality setting with no Gavi subsidy, rotavirus vaccination would be cost-effective. These estimates exclude the herd immunity benefits of vaccination, so represent a conservative estimate of the cost-effectiveness of rotavirus vaccination in Bangladesh.

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Section: Methodsmentioning

confidence: 99%

Impact and cost-effectiveness of rotavirus vaccination in Bangladesh

Pecenka

Parashar

Tate

et al. 2017

Vaccine

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“…18,49 However, it was also found that approximately 85% and 45% of the total cost of illness was incurred by the hospital for treating the rotavirus inpatients and outpatients respectively. 84…”

Section: Costs Of Illness Due To Childhood Rotavirusmentioning

confidence: 99%

Cost-effectiveness analysis of introducing universal childhood rotavirus vaccination in Bangladesh

Sarker

Sultana

Mahumud

et al. 2017

Human Vaccines & Immunotherapeutics

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Diarrhea is one of the world's leading killers of children, and globally, rotavirus is the most common cause of severe diarrhea among under 5 children. In Bangladesh, rotavirus kills nearly 6,000 under 5 children in each year. To reduce the burden of childhood rotavirus diseases, universal rotavirus vaccination is recommended by World Health Organization. The objective of this study is to assess the cost-effectiveness of introducing universal childhood rotavirus vaccination with the newly developed ROTAVAC vaccine in national Expanded Programme of Immunization in Bangladesh. We developed a decision model to examine the potential impact of vaccination in Bangladesh and to examine the effect if the vaccination is applied in the nationwide immunization program schedule. Introduction of childhood universal rotavirus vaccination in Bangladesh scenario appears as highly cost-effective and would offer substantial future benefits for the young population if vaccinated today. The cost per DALY averted of introducing the rotavirus vaccine compared with status quo is approximately US$ 740.27 and US$ 728.67 per DALY averted from the health system and societal perspective respectively which is "very cost-effective" using GDP threshold level according to World Health Organization definition. The results of this analysis seek to contribute to an evidence-based recommendation about the introduction of universal rotavirus vaccination in national Expanded Programme of Immunization (EPI) in Bangladesh.

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“…The choice of perspective can strongly influence ICER estimates and may highlight cases in which a program alleviates or exacerbates a large financial burden on patients or other segments of society. For example, an analysis of rotavirus vaccination showed that incorporating financial and productivity costs borne by patients decreased the ICER by 30%–75% [ 36 ]. Another article found that if cost estimates were reduced by the size of the subsidies provided by Gavi, rotavirus vaccination ICERs decreased by 50% [ 29 ].…”

Section: Next Steps Forward: Reconciling Cost-effectiveness and Afformentioning

confidence: 99%