Cost-effectiveness analysis of rotavirus vaccination in Argentina

Urueña, Analía; Pippo, Tomás; Betelu, María Sol; Virgilio, Federico; Hernández, Lissette Pérez; Giglio, Norberto; Gentile, Ángela; Diosque, Máximo; Vizzotti, Carla

doi:10.1016/j.vaccine.2014.12.074

Cited by 14 publications

(18 citation statements)

References 24 publications

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“…The model is designed to be used at the country-level to conduct cost-effectiveness analyses for three vaccines: Rotavirus vaccine, Pneumococcal conjugate vaccine, and Haemophilus influenza type b and provides a consistent and transparent framework for comparing the impact and cost-effectiveness of these vaccines [10]. The model has been widely used across the world to evaluate the cost-effectiveness of these vaccines [11], [12], [13], [14], [15], [16]. The model input parameters include: demographics, burden of disease, vaccine schedule, vaccine efficacy, vaccine coverage, vaccine costs, health service utilization, and health service costs.…”

Section: Methodsmentioning

confidence: 99%

Impact and cost-effectiveness of rotavirus vaccination in Bangladesh

Pecenka

Parashar

Tate

et al. 2017

Vaccine

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IntroductionDiarrheal disease is a leading cause of child mortality globally, and rotavirus is responsible for more than a third of those deaths. Despite substantial decreases, the number of rotavirus deaths in children under five was 215,000 per year in 2013. Of these deaths, approximately 41% occurred in Asia and 3% of those in Bangladesh. While Bangladesh has yet to introduce rotavirus vaccination, the country applied for Gavi support and plans to introduce it in 2018. This analysis evaluates the impact and cost-effectiveness of rotavirus vaccination in Bangladesh and provides estimates of the costs of the vaccination program to help inform decision-makers and international partners.MethodsThis analysis used Pan American Health Organization’s TRIVAC model (version 2.0) to examine nationwide introduction of two-dose rotavirus vaccination in 2017, compared to no vaccination. Three mortality scenarios (low, high, and midpoint) were assessed. Benefits and costs were examined from the societal perspective over ten successive birth cohorts with a 3% discount rate. Model inputs were locally acquired and complemented by internationally validated estimates.ResultsOver ten years, rotavirus vaccination would prevent 4000 deaths, nearly 500,000 hospitalizations and 3 million outpatient visits in the base scenario. With a Gavi subsidy, cost/disability adjusted life year (DALY) ratios ranged from $58/DALY to $142/DALY averted. Without a Gavi subsidy and a vaccine price of $2.19 per dose, cost/DALY ratios ranged from $615/DALY to $1514/DALY averted.ConclusionThe discounted cost per DALY averted was less than the GDP per capita for nearly all scenarios considered, indicating that a routine rotavirus vaccination program is highly likely to be cost-effective. Even in a low mortality setting with no Gavi subsidy, rotavirus vaccination would be cost-effective. These estimates exclude the herd immunity benefits of vaccination, so represent a conservative estimate of the cost-effectiveness of rotavirus vaccination in Bangladesh.

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Section: Methodsmentioning

confidence: 99%

Impact and cost-effectiveness of rotavirus vaccination in Bangladesh

Pecenka

Parashar

Tate

et al. 2017

Vaccine

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“…Several studies have indicated that Group A Rotavirus is responsible for 40% of hospital admissions for acute diarrhea, and it is estimated that it may cause between 30 and 50 deaths annually in our country [Bok et al, ; Gómez et al, ; Degiuseppe et al, ]. Considering the heavy burden of disease associated with this event, after a cost‐effectiveness analysis in Argentina, monovalent rotavirus vaccine was included in the routine immunization schedule on January 1, 2015 [Urueña et al, ].…”

Section: Introductionmentioning

confidence: 99%

Rotavirus epidemiology and surveillance before vaccine introduction in Argentina, 2012–2014

Degiuseppe

Reale

Stupka

2016

Journal of Medical Virology

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Group A Rotavirus has been widely described as one of the most important infantile diarrheal pathogens worldwide. In Argentina, it is responsible for over 200,000 acute diarrhea cases and from 30 to 50 deaths annually in children under 5 years. The aim of this study is to analyze frequency, seasonality, age group distribution, and circulating genotypes based on data notified in the 2012-2014 period and in turn to assess the pre-vaccine scenario, considering that rotavirus vaccine was introduced in 2015. Data were taken from the Viral Diarrhea Notification module of the Argentine SNVS-SIVILA surveillance tool. Analyses of circulating genotypes were performed on rotavirus-positive stool specimens by conventional binary characterization of the outermost capsid genes. Overall data showed rotavirus detection in about 25% of samples tested, and higher rates in children under 2 years old were observed. Rotavirus positive cases were distributed according to a typical winter seasonal pattern. A heterogeneous regional pattern of prevalence was also observed, with higher rates detected in the North region. Genotype co-circulation and annual fluctuation were observed. In general, G1P[8], G2P[4], G3P[8], and G12P[8] were the most frequently detected genotypes. This study represents the last survey taken of a population considered to be naïve. J. Med. Virol. 89:423-428, 2017. © 2016 Wiley Periodicals, Inc.

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“…Relative coverage was highlighted as Gavi’s principal equity indicator and a measure used to reflect the extent to which a certain programs’ coverage reaches those at higher risk. Relative coverage is a “derived indicator” based on wealth ratios and is calculated by the differences in coverage between the richest and the poorest quintiles [ 34 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

Accounting for equity considerations in cost-effectiveness analysis: a systematic review of rotavirus vaccine in low- and middle-income countries

Boujaoude

Mirelman

Dalziel

et al. 2018

Cost Eff Resour Alloc

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BackgroundCost-effectiveness analysis (CEA) is frequently used as an input for guiding priority setting in health. However, CEA seldom incorporates information about trade-offs between total health gains and equity impacts of interventions. This study investigates to what extent equity considerations have been taken into account in CEA in low- and middle-income countries (LMICs), using rotavirus vaccination as a case study.MethodsSpecific equity-related indicators for vaccination were first mapped to the Guidance on Priority Setting in Health Care (GPS-Health) checklist criteria. Economic evaluations of rotavirus vaccine in LMICs identified via a systematic review of the literature were assessed to explore the extent to which equity was considered in the research objectives and analysis, and whether it was reflected in the evaluation results.ResultsThe mapping process resulted in 18 unique indicators. Under the ‘disease and intervention’ criteria, severity of illness was incorporated in 75% of the articles, age distribution of the disease in 70%, and presence of comorbidities in 5%. For the ‘social groups’ criteria, relative coverage reflecting wealth-based coverage inequality was taken into account in 30% of the articles, geographic location in 27%, household income level in 8%, and sex at birth in 5%. For the criteria of ‘protection against the financial and social effects of ill health’, age weighting was incorporated in 43% of the articles, societal perspective in 58%, caregiver’s loss of productivity in 45%, and financial risk protection in 5%. Overall, some articles incorporated the indicators in their model inputs (20%) while the majority (80%) presented results (costs, health outcomes, or incremental cost-effectiveness ratios) differentiated according to the indicators. Critically, less than a fifth (17%) of articles incorporating indicators did so due to an explicit study objective related to capturing equity considerations. Most indicators were increasingly incorporated over time, with a notable exception of age-weighting of DALYs.ConclusionIntegrating equity criteria in CEA can help policy-makers better understand the distributional impact of health interventions. This study illustrates how equity considerations are currently being incorporated within CEA of rotavirus vaccination and highlights the components of equity that have been used in studies in LMICs. Areas for further improvement are identified.Electronic supplementary materialThe online version of this article (10.1186/s12962-018-0102-2) contains supplementary material, which is available to authorized users.

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Cost-effectiveness analysis of rotavirus vaccination in Argentina

Cited by 14 publications

References 24 publications

Impact and cost-effectiveness of rotavirus vaccination in Bangladesh

Impact and cost-effectiveness of rotavirus vaccination in Bangladesh

Rotavirus epidemiology and surveillance before vaccine introduction in Argentina, 2012–2014

Accounting for equity considerations in cost-effectiveness analysis: a systematic review of rotavirus vaccine in low- and middle-income countries

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