Abstract | OBJECTIVE: Rotavirus is the most common cause of severe diarrhea in children. Two rotavirus vaccines ( RotaTeq and Rotarix) have been licensed in Taiwan. We have investigated whether routine infant immunization with either vaccine could be cost-effective in Taiwan. METHODS: We modeled specific disease outcomes including hospitalization, emergency department visits, hospital outpatient visits, physician office visits, and death. Cost-effectiveness was analyzed from the perspectives of the health care system and society. A decision tree was used to estimate the disease burden and costs based on data from published and unpublished sources. RESULTS: A routine rotavirus immunization program would prevent 146,470 ( Rotarix) or 149,937 ( RotaTeq) cases of rotavirus diarrhea per year, and would prevent 21,106 ( Rotarix) and 23,057 ( RotaTeq) serious cases (hospitalizations, emergency department visits, and death). At US$80 per dose for the Rotarix vaccine, the program would cost US$32.7 million, provided an increasing cost offset of US$19.8 million to the health care system with $135 per case averted. Threshold analysis identified a break-even price per dose of US$27 from the health care system perspective and US$41 from a societal perspective. At US$60.0 per dose of RotaTeq vaccine, the program would cost US$35.4 million and provide an increasing cost offset of US$22.5 million to the health care system, or US$150 per case averted. Threshold analysis identified a break-even price per dose of US$20.0 from the health care system perspective and $29 from the societal perspective. Greater costs of hospitalization and lower vaccine price could increase cost-effectiveness. CONCLUSIONS: Despite a higher burden of serious rotavirus disease than estimated previously, routine rotavirus vaccination would unlikely be cost-saving in Taiwan at present unless the price fell to US$41 ( Rotarix) or US$29 ( RotaTeq) per dose from societal perspective, respectively. Nonetheless, rotavirus immunization could reduce the substantial burden of short-term morbidity due to rotavirus.
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Authors | Chia-Ling Wu, Yi-Ching Yang, Li-Min Huang, Kow-Tong Chen |
Journal | Vaccine
(Vaccine)
Vol. 27
Issue 10
Pg. 1492-9
(Mar 04 2009)
ISSN: 0264-410X [Print] Netherlands |
PMID | 19186200
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- RIX4414 vaccine
- RotaTeq
- Rotavirus Vaccines
- Vaccines, Attenuated
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Topics |
- Child, Preschool
- Cost-Benefit Analysis
- Decision Trees
- Gastroenteritis
(economics, prevention & control)
- Humans
- Infant
- Rotavirus Infections
(economics, prevention & control)
- Rotavirus Vaccines
(economics)
- Taiwan
- Vaccines, Attenuated
(economics)
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