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Researchers find rotavirus vaccination cost effective in most countries
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The introduction of rotavirus vaccination with either of the two available vaccines is cost effective and associated with significant decreases in disease burden, particularly in countries with low or lower-middle income and high child mortality, according to results of a hypothetical cohort study.
Despite the approval of two safe and effective rotavirus vaccines — two-dose monovalent (RV1; Rotarix, GlaxoSmithKline) and three-dose pentavalent (RV5; RotaTeq, Merck) — choosing either vaccine is complicated due to competing effectiveness and cost. This is particularly so in low and significantly low resource settings, according to study background.
Angel Paternina-Caicedo, MSc, of the National University of Columbia, and colleagues sought to assess and compare the cost-effectiveness of the two vaccines and their impact on child mortality as well as inpatient and outpatient visits across 116 low and middle income countries that consist of nearly 99% of rotavirus mortality.
The researchers used a decision tree model that included hypothetical cohorts of children from birth to 5 years of age for each country during 2010. Data were pooled from previous research on the effectiveness and incidence of both vaccines; all costs were in 2010 international dollars.
According to study results, with no vaccination, the researchers estimated that there would be 23.09 million outpatient cases, 3.34 million inpatient cases and 292,000 deaths. In addition, $987.83 million international dollars would have been spent in direct medical treatment costs during 2010.
Results of the base-case scenario indicate 54.7% of inpatient cases would be averted with RV1 vs. 51.4% with the RV5. In addition, RV1 would prevent 45.4% of deaths vs. 41.1% of deaths averted with RV5.
Regarding costs per disability-adjusted life-year averted, the researchers estimated $372 international dollars would be saved with RV1 and $453 international dollars with RV5.
“The present study is the first to assess competing choices of rotavirus vaccines and is a significant update to previous reports because new evidence on diarrheal burden of disease has recently emerged,” the researchers wrote. “The most important finding of our study shows rotavirus vaccination is justified in most world countries. Depending on the vaccine, as much as half of all rotavirus deaths would be prevented.” – by Jennifer Southall
Disclosure: The researchers report no relevant financial disclosures.
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