Rotavirus vaccination in northeast Brazil: A laudable intervention, but can it lead to cost-savings?

The economic burden of pediatric gastroenteritis to Bolivian families: a cross-sectional study of correlates of catastrophic cost and overall cost burden

“…Gastroenteritis presents an economic burden to both healthcare systems and patient families [3-5]. Though various studies have attempted to quantify the costs associated with pediatric diarrhea from the state perspective [3-12], fewer studies have specifically examined the perspective of the patient’s family [8-10,13-16], despite the burden that these costs may represent. Though health insurance may cover some costs associated with pediatric diarrhea, patient families often still incur substantial “direct” (i.e., out-of-pocket) and “indirect” (i.e., lost income) expenses [16-19].…”

“…Studies have estimated average total familial costs (direct and indirect) per episode of hospitalized pediatric diarrhea ranging from US$19.86 in Kenya (2007USD [6]) to US$215.88 in Mexico (2003USD [11]). Direct costs, alone, for a pediatric diarrhea episode have ranged from US$12.89 per case in Brazil (2007USD [13]) to US$31.83 per case in Vietnam (2004USD [4]). In a low-resource setting, these costs can represent a large proportion of a family’s overall budget.…”

The burden of pediatric diarrhea: a cross-sectional study of incurred costs and perceptions of cost among Bolivian families

“…In Vietnam (GDP per capita US$3,400 [14]) direct costs alone were found to amount to US$31.83 per case in one study [6]. Findings in somewhat wealthier countries included total incurred costs of US$215.88 [15] for hospitalized children in Mexico (GDP per capita US$14,800 [16]) and direct costs of US$12.89 [17] per case in Brazil (GDP per capita US$11,900 [18]).…”

Sustained Decrease in Gastroenteritis-related Deaths and Hospitalizations in Children Less Than 5 Years of Age After the Introduction of Rotavirus Vaccination

“…[14][15][16][17] Accounting for these secular trends has been a challenge for population-level impact studies conducted in Brazil since vaccine licensure in 2006. [18][19][20][21][22][23][24] For example, several studies used a short postvaccination period for comparison or did not account for pre-existing secular declines of outcomes, leaving an incomplete picture of the magnitude of vaccine impact or limiting their ability to distinguish the vaccine effect from other contributing factors, respectively. [18][19][20][21]23 In addition, despite the use of modeling to account for secular trends in a few mortality impact studies, extrapolation of these findings to real-world settings is limited because these analyses included only hospital administrative data or did not venture to compare findings on mortality between analyses of hospital administrative and death certificate data.…”

“…[18][19][20][21][22][23][24] For example, several studies used a short postvaccination period for comparison or did not account for pre-existing secular declines of outcomes, leaving an incomplete picture of the magnitude of vaccine impact or limiting their ability to distinguish the vaccine effect from other contributing factors, respectively. [18][19][20][21]23 In addition, despite the use of modeling to account for secular trends in a few mortality impact studies, extrapolation of these findings to real-world settings is limited because these analyses included only hospital administrative data or did not venture to compare findings on mortality between analyses of hospital administrative and death certificate data. 22,24 To address these limitations, we measured the population-level effect of nationwide vaccination on GE-related deaths using data from the Mortality Information System [SIM-a robust database that captures both hospital and non-hospital deaths (HDs)] and the Hospital Information System of the Brazilian Unified National Health System (SIH-SUS-a database for hospitalizations and HDs occurring in the public health system).…”