Abstract
IntroductionThe Palestinian Ministry of Health (MOH) started a routine rotavirus immunization program with ROTARIX in May 2016, with support for vaccine procurement and introduction provided through a global development organization. In 2018, financial responsibility for rotavirus vaccine procurement was transferred to the Palestinian government, which elected to shift to ROTAVAC vaccine because of its lower price per dose. This study aims to assess the cost, impact, and cost-effectiveness of rotavirus vaccination, specifically evaluating the economic implications of the change in vaccine product, accounting for the different characteristics of each rotavirus vaccine used.MethodsWe conducted primary and secondary data collection to assess the introduction, procurement, supply chain, and service delivery costs related to each vaccine. We used the UNIVAC model to project costs and benefits of rotavirus vaccination over a 10-year period comparing the use of ROTARIX versus no vaccination; ROTAVAC versus no vaccination; and ROTAVAC versus ROTARIX. We undertook scenario and probabilistic analyses to capture uncertainty in some of the study parameters. We used a 3% discount rate, and all costs are in 2018 US$.ResultsThe cost to deliver one dose was lower for ROTAVAC than ROTARIX (US$2.36 versus $2.70), but the total cost per course, excluding vaccine cost, favored ROTARIX ($7.09 versus $5.39). Both vaccines had high probability of being cost-effective interventions in Palestine compared to no vaccine. Because of lower vaccination program costs for ROTAVAC, however, switching from ROTARIX to ROTAVAC was cost-saving.ConclusionNational decision-makers should consider systematically assessing multiple criteria beyond vaccine price when comparing the health and economic value of several products in order to fully account for all characteristics including product presentation, number of doses per course, cold chain volume, cost of delivery, and wastage.
Highlights
IntroductionIntroduction of rotavirus vaccination in PalestineAn evaluation of the costs, impact, and cost-effectiveness of ROTARIX and ROTAVACFrederic DebellutID1*, Samer Jaber, Yaser Bouzya, Jehad Sabbah, Mustafa Barham, Fakhr Abu-Awwad, Diaa Hjaija, Assad Ramlawi, Clint Pecenka, Andrew Clark, Mercy Mvundura OPEN ACCESS
Introduction of rotavirus vaccination in PalestineAn evaluation of the costs, impact, and cost-effectiveness of ROTARIX and ROTAVACFrederic DebellutID1*, Samer Jaber2, Yaser Bouzya3, Jehad Sabbah4, Mustafa Barham5, Fakhr Abu-Awwad6, Diaa Hjaija3, Assad Ramlawi3, Clint Pecenka7, Andrew Clark8, Mercy Mvundura7 OPEN ACCESSCitation: Debellut F, Jaber S, Bouzya Y, Sabbah J, Barham M, Abu-Awwad F, et al (2020) Introduction of rotavirus vaccination in Palestine: An evaluation of the costs, impact, and costeffectiveness of ROTARIX and ROTAVAC
The cost to deliver one dose was lower for ROTAVAC than ROTARIX (US$2.36 versus $2.70), but the total cost per course, excluding vaccine cost, favored ROTARIX ($7.09 versus $5.39)
Summary
Introduction of rotavirus vaccination in PalestineAn evaluation of the costs, impact, and cost-effectiveness of ROTARIX and ROTAVACFrederic DebellutID1*, Samer Jaber, Yaser Bouzya, Jehad Sabbah, Mustafa Barham, Fakhr Abu-Awwad, Diaa Hjaija, Assad Ramlawi, Clint Pecenka, Andrew Clark, Mercy Mvundura OPEN ACCESS. To assess the costs linked to introducing ROTARIX in 2016 and the additional costs linked to switching products in 2018, we conducted key informant interviews within the Department of Public Health within the MOH to identify the activities that occurred with the rotavirus vaccine introduction and identify data sources. This is higher than the total economic cost linked with switching to ROTAVAC in 2018, amounting to $159,524 This is explained by the higher intensity of training activities related to introducing rotavirus vaccine for the first time. Fewer communication materials were developed for the switch to ROTAVAC Because of this cost difference, we elected to apply introduction costs of ROTARIX to both vaccines while doing the cost-effectiveness analysis. The cost-effectiveness acceptability curve displayed in Fig 2 shows the results of the probabilistic sensitivity analysis
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