Abstract
BackgroundRotavirus infection causes considerable disease burden of acute gastroenteritis (AGE) hospitalization and death among children less than 5 years in China. Although two rotavirus vaccines (Rotarix and RotaTeq) have been licensed in more than 100 countries in the world, the Lanzhou Lamb rotavirus vaccine (LLR) is the only vaccine licensed in China. This study aims to forecast the potential impacts of the two international vaccines compared to domestic LLR.MethodsAn economic evaluation was performed using a Markov simulation model. We compared costs at the societal aspect and health impacts with and without a vaccination program by LLR, Rotarix or RotaTeq. Parameters including demographic, epidemiological data, costs and efficacy of vaccines were obtained from literature review. The model incorporated the impact of vaccination on reduction of incidence of rotavirus infection and severity of AGE indicated by hospitalization, inpatient visits and deaths. Outcomes are presented in terms of quality-adjusted life years (QALYs) gained and incremental cost-effectiveness ratio (ICER) compared to status quo.ResultsIn a hypothetical cohort of 100,000 infants, the two international vaccines showed very good cost-effectiveness, with ICER of Rotateq and Rotarix shifting from LLR of $1715.11/QALY and $2105.66/QALY, respectively. Rotateq and Rotarix had significantly decreased incidence compared to LLR, particularly among infants aged 6 months to 2 years.ConclusionsRotaTeq is expected to introduce in the national routine immunization program to reduce disease burden of rotavirus infection with universal coverage.
Highlights
Rotavirus infection causes considerable disease burden of acute gastroenteritis (AGE) hospitalization and death among children less than 5 years in China
Lanzhou Lamb rotavirus vaccine (LLR) is the basic one with average cost-effectiveness ratio (ACER) of $110.68/ quality-adjusted lift year (QALY) gained
The incremental cost-effectiveness ration (ICER) of Rotateq and Rotarix shifting from LLR was $1715.11/QALY gained and $2105.66/QALY gained, respectively, indicating that the optimal pathway for children rotavirus vaccination starts at LLR and shift to Rotateq
Summary
Rotavirus infection causes considerable disease burden of acute gastroenteritis (AGE) hospitalization and death among children less than 5 years in China. Rotavirus is the most common cause of acute gastroenteritis (AGE) among children under 5 years of age and leads to substantial mortality and morbidities in both developing and developed countries [1]. Rotavirus causes approximately 111 million episodes of gastroenteritis requiring home care, leads to 25 million outpatients and 2 million hospitalizations [2]. In China, approximately 47.8 % of AGE hospitalization among underfive children attributed to rotavirus [4]. There are annually 134,000 deaths of children under 5 years due to rotavirus infection and about 70 % of them living in the rural area [6].
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