Abstract
BackgroundRotavirus gastroenteritis (RGE) is the leading cause of diarrhea in young children in Oman, incurring substantial healthcare and economic burden. We propose to formally assess the potential cost effectiveness of implementing universal vaccination with a pentavalent rotavirus vaccine (RV5) on reducing the health care burden and costs associated with rotavirus gastroenteritis (RGE) in OmanMethodsA Markov model was used to compare two birth cohorts, including children who were administered the RV5 vaccination versus those who were not, in a hypothetical group of 65,500 children followed for their first 5 years of life in Oman. The efficacy of the vaccine in reducing RGE-related hospitalizations, emergency department (ED) and office visits, and days of parental work loss for children receiving the vaccine was based on the results of the Rotavirus Efficacy and Safety Trial (REST). The outcome of interest was cost per quality-adjusted life year (QALY) gained from health care system and societal perspectives.ResultsA universal RV5 vaccination program is projected to reduce, hospitalizations, ED visits, outpatient visits and parental work days lost due to rotavirus infections by 89%, 80%, 67% and 74%, respectively. In the absence of RV5 vaccination, RGE-related societal costs are projected to be 2,023,038 Omani Rial (OMR) (5,259,899 United States dollars [USD]), including 1,338,977 OMR (3,481,340 USD) in direct medical costs. However, with the introduction of RV5, direct medical costs are projected to be 216,646 OMR (563,280 USD). Costs per QALY saved would be 1,140 OMR (2,964 USD) from the health care payer perspective. An RV5 vaccination program would be considered cost saving, from the societal perspective.ConclusionsUniversal RV5 vaccination in Oman is likely to significantly reduce the health care burden and costs associated with rotavirus gastroenteritis and may be cost-effective from the payer perspective and cost saving from the societal perspective.
Highlights
Rotavirus gastroenteritis (RGE) is the leading cause of diarrhea in young children in Oman, incurring substantial healthcare and economic burden
In the absence of a vaccination program, rotavirus gastroenteritis (RGE)-related societal costs of care are projected to be 2,023,038 Omani Rial (OMR) (5,259,899 United States dollars (USD)), including 1,338,977 OMR (3,481,340 USD) in direct medical costs, of which 65% was due to hospitalization
Sensitivity analyses The results of one-way sensitivity analyses from the payer and societal perspectives were most sensitive to the number of hospitalizations and hospitalization costs, followed by quality-adjusted life year (QALY) loss per episode, number of outpatient visits and outpatient visit costs (Figures 2, 3)
Summary
Rotavirus gastroenteritis (RGE) is the leading cause of diarrhea in young children in Oman, incurring substantial healthcare and economic burden. Rotavirus is the leading cause of severe gastroenteritis in children under age 5. Primary rotavirus infections provide substantial protection against gastroenteritis caused by the same serotype and against severe disease, regardless of serotype [15]. Since 2006, the World Health Organization (WHO) has recommended two oral rotavirus vaccines (RotaTeq® [RV5], Merck & Co.; and RotarixTM; GlaxoSmithKline Vaccines). Both have positively demonstrated safety and efficacy in clinical trials and effectiveness profiles, as well as impact in real world settings [15,16]
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