Beyond expectations: Post-implementation data shows rotavirus vaccination is likely cost-saving in Australia

Abstract

The inclusion of herd impact and declines in unspecified AGE hospitalisations resulted in the value for money achieved by the Australian rotavirus immunisation program being substantially greater than predicted bypre-implementation models, despite the potential increased cases of intussusception. This Australian experience is likely to be relevant to high-income countries yet to implement rotavirus vaccination programs.

Improving the Hospital Quality of Care during Winter Periods by Optimizing Budget Allocation Between Rotavirus Vaccination and Bed Expansion

“…The results of the exercise indicate that increased childhood vaccination could prevent or even reduce pediatric treatment care. This is now reflected in rotavirus vaccination post-implementation data, showing that when current-day pricing and herd effects are accounted for, the vaccination is cost effective and can even be cost saving [ 28 ]. The trade-off between vaccination and adding extra beds may in the future become the trade-off between vaccination and bed reduction in order to improve the QoC at a reasonable extra cost if more vaccination options against other infections are available.…”

Updated cost-effectiveness and risk-benefit analysis of two infant rotavirus vaccination strategies in a high-income, low-endemic setting

“…Based on the available literature, we assumed a vaccine-induced IS rate of 1:50,000 [ 32 – 35 ], whereof 4.8% would result in complications ([ 36 ], Table 1 ). The associated QALY loss for uncomplicated IS was 0.0037 [ 37 ], and costs were based on the average length of stay (LOS; 2.11 days) for IS in the Netherlands (Table 1 , see Additional file 1 for details). Threefold higher estimates, representing the 95% percentile of the LOS distribution, were used for complicated IS cases (see Additional file 1 for details).…”

Rotavirus detection and typing in the rotavirus vaccine era

“…Of children aged less than 5 years in Australia, for the period 1998 to 2003 which was prior to the introduction of rotavirus vaccines, there were typically about 10,000 hospital admissions (at an average cost of $1,890 each), 22,000 visits to emergency departments (each at a cost of $320), and 115,000 general practice consultations (at a cost of $36.60 each) annually for rotavirus infection alone, with an estimated direct health cost of $A30m according to the health cost data for 2005/6 (Galati et al, 2006). A more recent evaluation conducted by Reyes and team estimated that approximately 77,000 hospitalisations (at a cost of $ 2,350 each for 2007/8) were prevented by implementation of the rotavirus vaccine program (Reyes et al, 2017).…”

“…However, in a subsequent outbreak in the same region involving a non-vaccine related G2P[4] strain, a protective effect against severe disease was found only in a subset of infants less than 12 months of age, suggesting waning immunity in this highrisk population (Snelling et al, 2011). Nevertheless, a recent economic analysis found rotavirus vaccine was cost-saving for Australia, and over a 6-year period postimplementation from 2007-2012, an estimated 77,000 hospitalisations and 3 deaths were averted, compared with an estimated excess of 78 cases of intussusception associated with vaccination (5.6 cases per 100,000 vaccinated infants) (Reyes et al, 2017). The vaccine attributable risk of intussusception was estimated to be 4.3 cases per 100,000 infants for Rotarix recipients, and 7.0 cases per 100, 000 for RotaTeq (Carlin et al, 2013).…”

“…hospitalisations (17,000 coded rotavirus and 60,000 unspecified gastroenteritis) and 3 deaths were prevented (Reyes et al, 2017). However, these continued successes are contingent on vaccines providing adequate coverage against current circulating strains.…”