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Published on: January 28, 2019
Rotavirus-associated hospitalization and emergency department costs and rotavirus vaccine program impact
April Kilgore1, Stephanie Donauer, Kathryn M Edwards
1Department of Pediatrics, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Insights
The rotavirus vaccine significantly reduced healthcare costs, lowering annual medical expenses from $283 million to $96 million. This vaccine program demonstrates a substantial economic benefit by decreasing rotavirus hospitalizations and emergency department visits.
Area of Science:
- Public Health
- Epidemiology
- Health Economics
Background:
- Rotavirus is a leading cause of severe gastroenteritis in young children globally.
- Hospitalizations and emergency department (ED) visits for rotavirus incur significant medical costs.
- The introduction of rotavirus vaccines aimed to reduce disease burden and associated economic impact.
Purpose of the Study:
- To determine the medical costs associated with rotavirus hospitalizations and ED visits.
- To estimate the economic impact of the rotavirus vaccine program in the United States.
Main Methods:
- Active, population-based rotavirus surveillance was conducted in three US counties over four seasons (2006-2009).
- Medical costs were analyzed using hospital and physician billing data for children under 3 years old.
- National annual costs were estimated for pre- and post-vaccine periods using surveillance data.
Main Results:
- Pre-vaccine, rotavirus hospitalizations cost $91 million annually, with a median cost of $3581 per child.
- Post-vaccine, rotavirus hospitalizations decreased to $31 million annually, with a median cost of $4304 per child.
- Pre-vaccine, rotavirus ED visits cost $192 million annually; post-vaccine, this decreased to $65 million annually.
Conclusions:
- The rotavirus immunization program led to a substantial decrease in total annual medical costs, from $283 million to $96 million.
- This represents an annual cost saving of $187 million attributable to the vaccine.
- Factors influencing costs included study site, infant age, underlying conditions, and disease presentation.
Objectives:
To determine the medical costs of laboratory-confirmed rotavirus hospitalizations and emergency department (ED) visits and estimate the economic impact of the rotavirus vaccine program.
Patients And Methods:
During 4 rotavirus seasons (2006-2009), children <3 years of age hospitalized or seen in the ED with laboratory-confirmed rotavirus were identified through active population-based rotavirus surveillance in three US counties. Medical costs were obtained from hospital and physician billing data, and factors associated with increased costs were examined. Annual national costs were estimated using rotavirus hospitalization and ED visit rates and medical costs for rotavirus hospitalizations and ED visits from our surveillance program for pre- (2006-2007) and post-vaccine (2008-2009) time periods.
Results:
Pre-vaccine, for hospitalizations, the median medical cost per child was $3581, the rotavirus hospitalization rate was 22.1/10,000, with an estimated annual national cost of $91 million. Post-vaccine, the median medical cost was $4304, the hospitalization rate was 6.3/10,000 and the estimated annual national cost was $31 million. Increased costs were associated with study site, age <3 months, underlying medical conditions and an atypical acute gastroenteritis presentation. For ED visits, the pre-vaccine median medical cost per child was $574, the ED visit rate was 291/10,000 resulting in an estimated annual national cost of $192 million. Post-vaccine, the median medical cost was $794, the ED visit rate was 71/10,000 with an estimated annual national cost of $65 million.
Conclusions:
After implementation of rotavirus immunization, the total annual medical costs decreased from $283 million to $96 million, an annual reduction of $187 million.
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