Recommendation of rotavirus vaccination and herd effect: a budget impact analysis based on German health insurance data

Abstract

The objective of this study was to assess the budget impact and health effects of introducing rotavirus (RV) vaccination in Saxony, Germany, from a health insurance perspective. Special emphasis is given to the herd effect. We analyzed direct medical and non-medical costs of RV infection for Social Health Insurance between 2007 and 2010 based on 360,000 routine data observations from the AOK PLUS for children below 5 years of age. We compared the actual annual number of RV cases (vaccination scenario) with the number derived from 2005 (no vaccination, base case scenario). The vaccination coverage rate has increased from 5 % to 61 % between 2007 and 2010. The number of RV cases decreased by 21 % from 32,274 in 2007 to 25,614 in 2010. Based on vaccination coverage, the total cost savings per 1,000 children due to RV vaccination was estimated to be 39,686 Euros. The overall share of outpatient costs was 60 %. Mean gross cost savings were expected to be 304 Euros per avoided case. The net cost savings were expected to be 19 Euros per avoided case. About 59 % of total savings was due to herd protection resulting from increasing vaccine rates. The herd effect per avoided case increased with increasing vaccine coverage. Incidence of RV cases, vaccination costs and days absent from work were sensitive parameters. This retrospective analysis showed that the increase in RV vaccination coverage in Saxony has been budget neutral if not cost saving for sick funds.

Rotavirus vaccine effectiveness in preventing hospitalizations due to gastroenteritis: a descriptive epidemiological study from Germany

“…The number of prevented RVA infections without prior direct costs for vaccination is important in judging the cost effectiveness of vaccine programmes [21,22]. Therefore, the relative herd protection effect was assessed.…”

Vaccines are different: A systematic review of budget impact analyses of vaccines

“…Two of them were financially supported by the PCV13 producer [19,21] and the third study did not inform the funding, but one author had a grant from the PCV13 producer [20]. There is also evidence of herd protection with rotavirus vaccines [37] and out of four studies [16,22,25,30], two included herd protection in the analysis [16,22], one did not include it [30] and one did not mention it [25]. However, one must consider the evidence available at the time the studies were conducted.…”

“…These adverse events are rare and the benefits of vaccination surpass the risks [39,40], but these costs must be considered in economic evaluations and BIA. Two studies on rotavirus vaccines did not consider AEFI [25,30] and two did not mention them [16,22].…”

Evaluation of the Cost-Effectiveness of Vaccination of Children with 5-valent Vaccine against Rotavirus Infection in the Russian Federation

“…Ранее суще-ственная доля предотвращенных затрат в невакциниро-ванной популяции (59% общего объема предотвращенных затрат) была продемонстрирована в Германии [37]. Это подчеркивает необходимость именно массовой вакцина-ции, обеспечивающей развитие популяционного эффекта.…”

“…Анализ с учетом только затрат системы здравоохранения также продемонстри-ровал приемлемый уровень эффективности затрат на вакцинацию против РВИ, хотя в этом случае экономиче-ская эффективность вакцинации ниже, чем при исполь-зовании социальной перспективы, предполагающей учет всех затрат, обусловленных заболеваемостью РВИ. Обращает на себя внимание резкое (в 4,94 раза) сниже-ние эффективности затрат при выборочной вакцинации по сравнению с базовым вариантом, что подчеркивает целесообразность именно массовой вакцинации [6,30,37,[40][41][42][43][44][45][46]. ЗАКЛЮЧЕНИЕ Таким образом, проведенное исследование пока-зало, что, как и во многих других странах с различным уровнем развития экономики и различающимся уров-нем заболеваемости РВИ, массовая вакцинация детей 5-валентной вакциной против РВИ в РФ позволит не только снизить заболеваемость, но, с учетом принятых допущений, может также рассматриваться как экономи-чески эффективное вмешательство.…”