TY - JOUR T1 - Cost-effectiveness of childhood rotavirus vaccination in Germany. AU - Aidelsburger,Pamela, AU - Grabein,Kristin, AU - Böhm,Katharina, AU - Dietl,Markus, AU - Wasem,Jürgen, AU - Koch,Judith, AU - Ultsch,Bernhard, AU - Weidemann,Felix, AU - Wichmann,Ole, Y1 - 2014/02/20/ PY - 2013/04/05/received PY - 2013/12/17/revised PY - 2014/01/22/accepted PY - 2014/2/25/entrez PY - 2014/2/25/pubmed PY - 2014/8/26/medline KW - Cost effectiveness KW - Germany KW - Health economic evaluation KW - Markov model KW - Rotavirus KW - Vaccination SP - 1964 EP - 74 JF - Vaccine JO - Vaccine VL - 32 IS - 17 N2 - BACKGROUND: Rotavirus (RV) causes a highly contagious gastroenteritis especially in children under five years of age. Since 2006 two RV-vaccines are available in Europe (Rotarix(®) and RotaTeq(®)). To support informed decision-making within the German Standing Committee on Vaccination (STIKO) the cost-effectiveness of these two vaccines was evaluated for the German healthcare setting. METHODS: A Markov model was developed to evaluate the cost-effectiveness from the statutory health insurance (SHI) and from the societal perspective. RV-cases prevented, RV-associated hospitalizations avoided, and quality-adjusted life years (QALY) gained were considered as health outcomes. RV-incidences were calculated based on data from the national mandatory disease reporting system. RV-vaccine efficacy was determined as pooled estimates based on data from randomized controlled trials. Vaccine list prices and price catalogues were used for cost-assessment. Effects and costs were discounted with an annual discount rate of 3%. RESULTS: The base-case analysis (SHI-perspective) resulted in an incremental cost-effectiveness and cost-utility ratio for Rotarix(®) of € 184 per RV-case prevented, € 2457 per RV-associated hospitalization avoided, and € 116,973 per QALY gained. For RotaTeq(®), the results were € 234 per RV-case prevented, € 2622 per RV-associated hospitalization avoided, and € 142,732 per QALY gained. Variation of various parameters in sensitivity analyses showed effects on the ICERs without changing the overall trend of base-case results. When applying base-case results to the 2012 birthcohort in Germany with 80% vaccination coverage, an estimated 206,000-242,000 RV-cases and 18,000 RV-associated hospitalizations can be prevented in this birthcohort over five years for an incremental cost of 44.5-48.2 million €. CONCLUSION: Our analyses demonstrate that routine RV-vaccination could prevent a substantial number of RV-cases and hospitalizations in the German healthcare system, but the saved treatment costs are counteracted by costs for vaccination. However, with vaccine prices reduced by ∼62-66%, RV-vaccination could even become a cost-saving preventive measure. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/24561052/Cost_effectiveness_of_childhood_rotavirus_vaccination_in_Germany_ DB - PRIME DP - Unbound Medicine ER -