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Cost-effectiveness of a pentavalent human-bovine reassortant rotavirus vaccine for children ≤5 years of age in Taiwan.
J Med Econ. 2011; 14(6):748-58.JM

Abstract

OBJECTIVE

A Markov model was used to assess the impact of RV5, a pentavalent (G1, G2, G3, G4, P1A[8]) human bovine (WC3 strain) reassortant rotavirus vaccine, on reducing the healthcare burden and cost associated with rotavirus gastroenteritis (RGE) in Taiwan. Other cost-effectiveness analyses for rotavirus vaccination in industrialized countries have produced varying results depending on the input parameters assumed.

METHODS

Vaccination with RV5 is compared to no vaccination in a hypothetical cohort of Taiwanese children during their first 5 years of life to determine the per dose prices at which vaccination would be cost neutral or provide good value based on established standards from the healthcare (direct medical care costs only) and societal (all RGE-related costs) perspectives. The effects of vaccination on RGE healthcare utilization and days of parental work loss missed are based on results from the Rotavirus Efficacy and Safety Trial.

RESULTS

Without vaccination there would be 122,526 symptomatic episodes of RGE. Universal vaccination would reduce RGE-related deaths, hospitalizations, emergency department, and outpatient visits by 91.7%, 92.1%, 83.7%, and 73.4%, respectively. The price per dose at which vaccination would be cost-neutral is US$ 21.80 (688 NTD) and US$ 26.20 (827 NTD) from the healthcare and societal perspectives, respectively. At $25 per dose, the cost per QALY gained is US$ 2261 (71,335 NTD) from the healthcare perspective and cost saving from the societal perspective. KEY LIMITATION: The model only assesses the effect of RV5 on vaccinated children and does not account for herd immunity. However, given that high levels of coverage are anticipated in Taiwan, the effects of herd immunity are likely to be short-term.

CONCLUSION

A pentavalent rotavirus vaccination program is likely to substantially reduce the healthcare burden associated with rotavirus gastroenteritis at a cost per QALY ratio within the range defined as cost-effective.

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Publisher Full Text

Authors+Show Affiliations

Itzler RF
Merck & Co., Inc, North Wales, PA 19454-2505, USA. robbin_itzler@merck.com
Chen PY
No affiliation info available
Lac C
No affiliation info available
El Khoury AC
No affiliation info available
Cook JR
No affiliation info available

MeSH

AbsenteeismAdolescentCost-Benefit AnalysisGastroenteritisHealth ServicesHumansImmunization ProgramsMarkov ChainsQuality-Adjusted Life YearsReproducibility of ResultsRotavirus InfectionsRotavirus VaccinesTaiwanVaccines, Attenuated

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21919673

Citation

Itzler, Robbin F., et al. "Cost-effectiveness of a Pentavalent Human-bovine Reassortant Rotavirus Vaccine for Children ≤5 Years of Age in Taiwan." Journal of Medical Economics, vol. 14, no. 6, 2011, pp. 748-58.
Itzler RF, Chen PY, Lac C, et al. Cost-effectiveness of a pentavalent human-bovine reassortant rotavirus vaccine for children ≤5 years of age in Taiwan. J Med Econ. 2011;14(6):748-58.
Itzler, R. F., Chen, P. Y., Lac, C., El Khoury, A. C., & Cook, J. R. (2011). Cost-effectiveness of a pentavalent human-bovine reassortant rotavirus vaccine for children ≤5 years of age in Taiwan. Journal of Medical Economics, 14(6), 748-58. https://doi.org/10.3111/13696998.2011.614303
Itzler RF, et al. Cost-effectiveness of a Pentavalent Human-bovine Reassortant Rotavirus Vaccine for Children ≤5 Years of Age in Taiwan. J Med Econ. 2011;14(6):748-58. PubMed PMID: 21919673.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of a pentavalent human-bovine reassortant rotavirus vaccine for children ≤5 years of age in Taiwan. AU - Itzler,Robbin F, AU - Chen,Po Yen, AU - Lac,Christina, AU - El Khoury,Antoine C, AU - Cook,John R, Y1 - 2011/09/15/ PY - 2011/9/17/entrez PY - 2011/9/17/pubmed PY - 2012/3/10/medline SP - 748 EP - 58 JF - Journal of medical economics JO - J Med Econ VL - 14 IS - 6 N2 - OBJECTIVE: A Markov model was used to assess the impact of RV5, a pentavalent (G1, G2, G3, G4, P1A[8]) human bovine (WC3 strain) reassortant rotavirus vaccine, on reducing the healthcare burden and cost associated with rotavirus gastroenteritis (RGE) in Taiwan. Other cost-effectiveness analyses for rotavirus vaccination in industrialized countries have produced varying results depending on the input parameters assumed. METHODS: Vaccination with RV5 is compared to no vaccination in a hypothetical cohort of Taiwanese children during their first 5 years of life to determine the per dose prices at which vaccination would be cost neutral or provide good value based on established standards from the healthcare (direct medical care costs only) and societal (all RGE-related costs) perspectives. The effects of vaccination on RGE healthcare utilization and days of parental work loss missed are based on results from the Rotavirus Efficacy and Safety Trial. RESULTS: Without vaccination there would be 122,526 symptomatic episodes of RGE. Universal vaccination would reduce RGE-related deaths, hospitalizations, emergency department, and outpatient visits by 91.7%, 92.1%, 83.7%, and 73.4%, respectively. The price per dose at which vaccination would be cost-neutral is US$ 21.80 (688 NTD) and US$ 26.20 (827 NTD) from the healthcare and societal perspectives, respectively. At $25 per dose, the cost per QALY gained is US$ 2261 (71,335 NTD) from the healthcare perspective and cost saving from the societal perspective. KEY LIMITATION: The model only assesses the effect of RV5 on vaccinated children and does not account for herd immunity. However, given that high levels of coverage are anticipated in Taiwan, the effects of herd immunity are likely to be short-term. CONCLUSION: A pentavalent rotavirus vaccination program is likely to substantially reduce the healthcare burden associated with rotavirus gastroenteritis at a cost per QALY ratio within the range defined as cost-effective. SN - 1941-837X UR - https://www.unboundmedicine.com/medline/citation/21919673/Cost_effectiveness_of_a_pentavalent_human_bovine_reassortant_rotavirus_vaccine_for_children_≤5_years_of_age_in_Taiwan_ L2 - https://www.tandfonline.com/doi/full/10.3111/13696998.2011.614303 DB - PRIME DP - Unbound Medicine ER -