Economic assessment of rotavirus vaccination in Saudi Arabia

In the Kingdom of Saudi Arabia (KSA), rotavirus universal mass vaccination has been introduced in 2013, however, there is limited information available on the economic benefit and the epidemiological impact of the programme to date. We used a Markov cohort model to evaluate and compare the economic value of rotavirus vaccination with no vaccination in a birth cohort of 562,428 infants. This lifetime analysis considered the societal perspective. Model input was obtained through consensus of local experts after two rounds of evaluation of the proposed estimates. The primary outcome measure was to assess cost-effectiveness and to define the cost-neutrality level reached by comparing vaccination with no vaccination as a function of the price adjustment of the vaccination course. With an assumed vaccine coverage rate of 96%, the already started rotavirus vaccination is expected to reduce the overall burden of rotavirus gastroenteritis by 65% with model exercise, over lifetime. The maximum impact will be seen in rotavirus gastroenteritis-related hospitalizations (93%). Outpatient and emergency visits are shown to decline by 87% each while the occurrence of nosocomial infections, by 78%. Cost neutrality is reached if the vaccine price per course is less than SAR 178.20 at steady state. Rotavirus vaccination should be recommended in KSA given the important clinical impact the vaccine can have and the good value for money it can obtain.