Disease burden and related medical costs of rotavirus infections in Taiwan

Abstract

BackgroundThe disease burden and associated medical costs of rotavirus infections in inpatient and outpatient sectors in Taiwan were examined in anticipation of the availability of new rotavirus vaccines.MethodsThe yearly national case number and medical costs for all for inpatients and outpatients with acute gastroenteritis (AGE) were extracted from the Bureau of National Health Insurance database in Taiwan according to ICD-9-CM codes. A retrospective study was also performed using records of children with AGE seen at three hospitals in Taiwan in 2001 to identify laboratory confirmed rotavirus infection cases. The annual incidence and related medical costs of AGE due to rotavirus infection were then estimated.ResultsChildren <5 years old comprised 83.6% of inpatient and 62.0% of outpatient pediatric AGE cases in Taiwan in 2001. Rotavirus was the most common agent detected among AGE patients in this age group in the three hospitals, and was detected in 32.9% (221/672) of inpatient and 24% (23/96) of outpatient stool specimens tested for microbial etiologies. An estimated 277,400 to 624,892 cases of rotavirus infections sought medical care in Taiwan in 2001, equaling one in 2 to 5 children <5 years old required medical care due to rotavirus infection. The incidence of hospitalization due to rotavirus infections was 1,528–1,997/100,000 for children <5 years old. The total associated medical costs due to rotavirus infection were estimated at US $10–16 millions in Taiwan in 2001. Although the per-capita medical cost of rotavirus infection was lower in Taiwan than in the United States or Hong Kong, the personal economic burden was similar among the three places when normalized for gross national incomes per capita.ConclusionInfections caused by rotavirus constitute an important human and economic burden among young children in Taiwan. A safe and effective vaccine is urgently needed.

Modeling seasonal variation in rotavirus hospitalizations for use in evaluating the effect of rotavirus vaccine

“…This incidence looked much higher compared with an incidence of 3.8 and 4.9 per 1,000 child-years observed in two other sentinel hospitals in another region of Japan [Kamiya et al, 2009]. The incidence of rotavirus hospitalizations in Japan (a median of 9.0 in the four reports from Japan) was similar to the median incidence of 7.8 per 1,000 children less than 5 years of age (range: 2.5-20.0) in 11 developed countries [Nakagomi et al, 2005[Nakagomi et al, , 2009Nelson et al, 2005;Podewils et al, 2005;Lu et al, 2006;Chen et al, 2007;Fischer et al, 2007;Huet et al, 2007;Jit and Edmunds, 2007;Newall et al, 2007;Widdowson et al, 2007;Goossens et al, 2008;Luquero et al, 2008;Melliez et al, 2008;Kamiya et al, 2009;Martin et al, 2009;Panatto et al, 2009;Wu et al, 2009].…”

Cost-effectiveness of a pentavalent human–bovine reassortant rotavirus vaccine for children≤5 years of age in Taiwan

“…The differences in study results, often within the same country, are largely due to differences in the input parameters assumed 26 . Although another cost-effectiveness analysis for rotavirus vaccination was published in Taiwan, the estimates of hospitalizations and ambulatory visits included in the base case in that study were lower than other published studies in Taiwan [3][4][5]10 . In addition, the study did not include the cost per quality adjusted life year (QALY) as an outcome measure.…”

“…These estimates are then varied based on other published studies from Taiwan [3][4][5]10 . The results are presented for the prices at which universal vaccination would be cost-neutral as well as the cost per quality adjusted life years gained for prices ranging from US$20-30 per dose.…”

“…Until now, vaccine use has been limited to the private sector and studies are currently being conducted in preparation for public sector reimbursement 7,8 . Government reimbursement would significantly help to increase the coverage rates in Taiwan because nearly all children are covered by the Taiwanese government's national health insurance program 4,9,10 .…”

“…In industrialized countries deaths due to RGE are relatively rare but healthcare costs are substantial. In Taiwan, estimates of RGE-related annual healthcare costs range from US$10-18.5 million 4,5 .…”