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Clinical and cost burden of rotavirus infection before and after introduction of rotavirus vaccines among commercially and Medicaid insured children in the United States.

Abstract
This study aims to quantify clinical and economic burden of rotavirus (RV) infection pre- and post-vaccine introduction in commercially insured and Medicaid populations. Beneficiaries with continuous enrollment for ≥6 months while <5 years of age were identified separately in commercial (2000-2010) and Medicaid (2002-2009) claims databases. Commercial and Medicaid databases included 3,998,708 and 1,034,440 eligible children, respectively, observed from enrollment start date(s) to end of eligibility or 5-years-old. Rates of RV-coded and diarrhea-coded encounters and first RV episodes, and incremental cost of first RV episodes were calculated. In the post-vaccine period, rates per 10,000 person-years for RV-coded hospitalizations, outpatient visits and ER visits were 5.58 (95% CI, 5.37-5.80), 6.96 (95% CI, 6.75-7.20), and 4.85 (95% CI, 4.66-5.06), respectively (pre-vaccine, 16.67 [95% CI, 16.19-17.15], 13.20 [95% CI, 12.78-13.63], 11.26 [95% CI, 10.87-11.66], respectively), for commercially insured. In Medicaid the corresponding rates were 10.53 (95% CI, 9.60-11.56), 11.72 (95% CI, 10.73-12.80), and 9.11 (95% CI, 8.24-10.07) (pre-vaccine, 19.78 [95% CI, 19.14-20.45], 19.39 [95% CI, 18.75-20.05], 27.61 [95% CI, 26.84-28.40]). Incidence rate per 10,000 person-years for first RV episode pre- vs. post-vaccine were 27.03 (95% CI, 26.42-27.65) vs. 10.14 (95% CI, 9.86-10.44) in the commercially insured population and 37.71 (95% CI, 36.81-38.63) vs. 18.64 (95% CI, 17.37-19.99) in Medicaid. Incremental per-patient per-month cost of first RV episode was $3363 (95% CI, $3308-$3418) among commercially insured and $1831 (95% CI, $1768-$1887) in Medicaid. Since vaccine introduction clinical burden of RV disease decreased among children; costs associated with RV episodes remained significant across insured populations.
AuthorsGirishanthy Krishnarajah, Kitaw Demissie, Patrick Lefebvre, Sunanda Gaur, Mei Sheng Duh
JournalHuman vaccines & immunotherapeutics (Hum Vaccin Immunother) Vol. 10 Issue 8 Pg. 2255-66 ( 2014) ISSN: 2164-554X [Electronic] United States
PMID25424930 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Rotavirus Vaccines
Topics
  • Child, Preschool
  • Cohort Studies
  • Female
  • For-Profit Insurance Plans
  • Health Care Costs
  • Humans
  • Infant
  • Infant, Newborn
  • Longitudinal Studies
  • Male
  • Medicaid
  • Prevalence
  • Retrospective Studies
  • Rotavirus Infections (economics, epidemiology, prevention & control)
  • Rotavirus Vaccines (administration & dosage)
  • United States (epidemiology)

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