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Cost-effectiveness analysis of rotavirus vaccination in Argentina.
Vaccine. 2015 May 07; 33 Suppl 1:A126-34.V

Abstract

BACKGROUND

Rotavirus is a leading cause of severe diarrhea in children under 5. In Argentina, the most affected regions are the Northeast and Northwest, where hospitalizations and deaths are more frequent. This study estimated the cost-effectiveness of adding either of the two licensed rotavirus vaccines to the routine immunization schedule.

METHODS

The integrated TRIVAC vaccine cost-effectiveness model from the Pan American Health Organization's ProVac Initiative (Version 2.0) was used to assess health benefits, costs savings, life-years gained (LYGs), DALYs averted, and cost/DALY averted of vaccinating 10 successive cohorts, from the health care system and societal perspectives. Two doses of monovalent (RV1) rotavirus vaccine and three doses of pentavalent (RV5) rotavirus vaccine were each compared to a scenario assuming no vaccination. The price/dose was US$ 7.50 and US$ 5.15 for RV1 and RV5, respectively. We ran both a national and sub-national analysis, discounting all costs and benefits 3% annually. Our base case results were compared to a range of alternative univariate and multivariate scenarios.

RESULTS

The number of LYGs was 5962 and 6440 for RV1 and RV5, respectively. The cost/DALY averted when compared to no vaccination from the health care system and societal perspective was: US$ 3870 and US$ 1802 for RV1, and US$ 2414 and US$ 358 for RV5, respectively. Equivalent figures for the Northeast were US$ 1470 and US$ 636 for RV1, and US$ 913 and US$ 80 for RV5. Therefore, rotavirus vaccination was more cost-effective in the Northeast compared to the whole country; and, in the Northwest, health service's costs saved outweighed the cost of introducing the vaccine. Vaccination with either vaccine compared to no vaccination was highly cost-effective based on WHO guidelines and Argentina's 2011 per capita GDP of US$ 9090. Key variables influencing results were vaccine efficacy, annual loss of efficacy, relative coverage of deaths, vaccine price, and discount rate.

CONCLUSION

Compared to no vaccination, routine vaccination against rotavirus in Argentina would be highly cost-effective with either vaccine. Health and economic benefits would be higher in the Northeast and Northwest regions, where the intervention would even be cost-saving.

Authors+Show Affiliations

Ministerio de Salud de la Nación, Av. 9 de Julio 1925 (C1073ABA) , Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: uruenaanalia@gmail.com.Ministerio de Salud de la Nación, Av. 9 de Julio 1925 (C1073ABA) , Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: tpippo@msal.gov.ar.Ministerio de Salud de la Nación, Av. 9 de Julio 1925 (C1073ABA) , Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: solbetelu@hotmail.com.Ministerio de Salud de la Nación, Av. 9 de Julio 1925 (C1073ABA) , Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: federicomv82@hotmail.com.Ministerio de Salud de la Nación, Av. 9 de Julio 1925 (C1073ABA) , Ciudad Autónoma de Buenos Aires, Argentina.Hospital de Niños "Dr. Ricardo Gutiérrez," Gallo 1330 (1425), Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: norbergiglio@gmail.com.Sociedad Argentina de Pediatría, Av. Coronel Díaz 1971/75 (C1425DQF), Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: angelagentile@fibertel.com.ar.Ministerio de Salud de la Nación, Av. 9 de Julio 1925 (C1073ABA) , Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: mdiosque@msal.gov.ar.Ministerio de Salud de la Nación, Av. 9 de Julio 1925 (C1073ABA) , Ciudad Autónoma de Buenos Aires, Argentina. Electronic address: cvizzotti@yahoo.com.ar.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25919152

Citation

Urueña, Analía, et al. "Cost-effectiveness Analysis of Rotavirus Vaccination in Argentina." Vaccine, vol. 33 Suppl 1, 2015, pp. A126-34.
Urueña A, Pippo T, Betelu MS, et al. Cost-effectiveness analysis of rotavirus vaccination in Argentina. Vaccine. 2015;33 Suppl 1:A126-34.
Urueña, A., Pippo, T., Betelu, M. S., Virgilio, F., Hernández, L., Giglio, N., Gentile, Á., Diosque, M., & Vizzotti, C. (2015). Cost-effectiveness analysis of rotavirus vaccination in Argentina. Vaccine, 33 Suppl 1, A126-34. https://doi.org/10.1016/j.vaccine.2014.12.074
Urueña A, et al. Cost-effectiveness Analysis of Rotavirus Vaccination in Argentina. Vaccine. 2015 May 7;33 Suppl 1:A126-34. PubMed PMID: 25919152.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness analysis of rotavirus vaccination in Argentina. AU - Urueña,Analía, AU - Pippo,Tomás, AU - Betelu,María Sol, AU - Virgilio,Federico, AU - Hernández,Laura, AU - Giglio,Norberto, AU - Gentile,Ángela, AU - Diosque,Máximo, AU - Vizzotti,Carla, PY - 2014/05/10/received PY - 2014/12/11/revised PY - 2014/12/12/accepted PY - 2015/4/29/entrez PY - 2015/4/29/pubmed PY - 2016/1/30/medline KW - Argentina KW - Cost-effectiveness KW - Rotavirus vaccination SP - A126 EP - 34 JF - Vaccine JO - Vaccine VL - 33 Suppl 1 N2 - BACKGROUND: Rotavirus is a leading cause of severe diarrhea in children under 5. In Argentina, the most affected regions are the Northeast and Northwest, where hospitalizations and deaths are more frequent. This study estimated the cost-effectiveness of adding either of the two licensed rotavirus vaccines to the routine immunization schedule. METHODS: The integrated TRIVAC vaccine cost-effectiveness model from the Pan American Health Organization's ProVac Initiative (Version 2.0) was used to assess health benefits, costs savings, life-years gained (LYGs), DALYs averted, and cost/DALY averted of vaccinating 10 successive cohorts, from the health care system and societal perspectives. Two doses of monovalent (RV1) rotavirus vaccine and three doses of pentavalent (RV5) rotavirus vaccine were each compared to a scenario assuming no vaccination. The price/dose was US$ 7.50 and US$ 5.15 for RV1 and RV5, respectively. We ran both a national and sub-national analysis, discounting all costs and benefits 3% annually. Our base case results were compared to a range of alternative univariate and multivariate scenarios. RESULTS: The number of LYGs was 5962 and 6440 for RV1 and RV5, respectively. The cost/DALY averted when compared to no vaccination from the health care system and societal perspective was: US$ 3870 and US$ 1802 for RV1, and US$ 2414 and US$ 358 for RV5, respectively. Equivalent figures for the Northeast were US$ 1470 and US$ 636 for RV1, and US$ 913 and US$ 80 for RV5. Therefore, rotavirus vaccination was more cost-effective in the Northeast compared to the whole country; and, in the Northwest, health service's costs saved outweighed the cost of introducing the vaccine. Vaccination with either vaccine compared to no vaccination was highly cost-effective based on WHO guidelines and Argentina's 2011 per capita GDP of US$ 9090. Key variables influencing results were vaccine efficacy, annual loss of efficacy, relative coverage of deaths, vaccine price, and discount rate. CONCLUSION: Compared to no vaccination, routine vaccination against rotavirus in Argentina would be highly cost-effective with either vaccine. Health and economic benefits would be higher in the Northeast and Northwest regions, where the intervention would even be cost-saving. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/25919152/Cost_effectiveness_analysis_of_rotavirus_vaccination_in_Argentina_ DB - PRIME DP - Unbound Medicine ER -