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Published on: January 28, 2019
[A cost-effectiveness analysis on universal infant rotavirus vaccination strategy in China]
1Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.
Insights
Both Rotarix and Rotateq rotavirus vaccines are cost-effective for infants in China. Rotarix is recommended over Rotateq due to lower costs and simpler administration, making it a practical choice for routine immunization programs.
Area of Science:
- Public Health
- Health Economics
- Vaccinology
Background:
- Rotavirus diarrhea poses a significant health burden in infants globally.
- China's current infant vaccination strategy requires cost-effectiveness evaluation.
- Understanding the economic impact of different rotavirus vaccines is crucial for public health policy.
Purpose of the Study:
- To assess the cost-effectiveness of universal infant rotavirus vaccination in China.
- To compare Rotarix and Rotateq vaccination programs against no vaccination.
- To determine the optimal rotavirus vaccination strategy for China.
Main Methods:
- A decision tree-Markov model was constructed to simulate costs and health outcomes.
- Newborns in 2012 were analyzed under no vaccination, Rotarix, and Rotateq programs.
- Incremental Cost-Effectiveness Ratio (ICER) was compared against China's 2012 per capita GDP.
Main Results:
- Rotarix and Rotateq vaccination averted one Disability-Adjusted Life Year (DALY) loss at costs below China's 2012 per capita GDP.
- Sensitivity analysis confirmed the robustness of these findings.
- Rotateq incurred significantly higher costs per DALY averted compared to Rotarix, with non-robust sensitivity analysis results.
Conclusions:
- Both Rotarix and Rotateq vaccination programs are highly cost-effective compared to no vaccination.
- Integrating rotavirus vaccines into routine immunization programs is appropriate.
- Rotarix is recommended over Rotateq due to lower incremental costs and practical considerations, despite Rotateq's efficacy.
Objective:
To evaluate the cost-effectiveness of current universal infant rotavirus vaccination strategy, in China.
Methods:
Through constructing decision tree-Markov model, we simulated rotavirus diarrhea associated cost and health outcome on those newborns in 2012 regarding different vaccination programs as: group with no vaccination, Rotavirus vaccination group and Rotateq vaccination group, respectively. We determined the optimal program, based on the comparison between incremental cost-effectiveness ratio (ICER) and China' s 2012 per capital gross domestic product (GDP).
Results:
Compared with non-vaccination group, the Rotavirus vaccination and Rotateq vaccination groups had to pay 3 760 Yuan and 7 578 Yuan (both less than 2012 GDP per capital) to avert one disability adjusted life years (DALY) loss, respectively. RESULTS from sensitivity analysis indicated that both results were robust. Compared with Rotavirus vaccination program, the Rotateq vaccination program had to pay extra 81 068 Yuan (between 1 and 3 times GDP per capital) to avert one DALY loss. Data from the sensitivity analysis indicated that the result was not robust.
Conclusion:
From the perspective of health economics, both two-dose Rotarix vaccine and three-dose' s Rotateq vaccine programs were highly cost-effective, when compared to the non-vaccination program. It was appropriate to integrate rotavirus vaccine into the routine immunization program. Considering the large amount of extra cost that had to spend on Rotateq vaccination program, results from the sensitivity analysis showed that it was not robust. Rotateq vaccine required one more dose than the Rotarix vaccine, to be effective. However, it appeared more difficult to practice, suggesting that it was better to choose the Rotarix vaccine, at current stage.
