PIN20 Cost-Effectiveness Analysis of Universal Vaccination with Pentavalent Vaccine in Russia

Abstract

To assess the cost-effectiveness of universal pentavalent rotavirus vaccination compared to no vaccination from the societal perspective in Russia. We developed an age-structured deterministic dynamic transmission model and estimated the averted outcomes and cost-effectiveness of rotavirus vaccination over a time horizon of 50 years. Parameter values were obtained from the published modeling and epidemiologic literature for rotavirus transmission, registered vaccination prices (VAT: 2084.39/€27.40), Russian surveillance data, and consultation with local experts. Based on Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing data, we considered the under-reporting fraction to be 66.1%. (which means that the incidence data is constructed based on 33.9% confirmed data and 66.1% unconfirmed data). Over 50 years, rotavirus vaccination in Russia is expected to avert 16.29 million Rotavirus Gastroenteritis (RVGE) cases, resulting in a gain of 53,221 QALYs (or 1,064 QALYs annually) compared to no vaccination. From a societal perspective, without vaccination, the cost of care for RVGE cases was projected to be 346,752,521,944 (€4,558,346,702) over 50 years or 6,935,050,438 (€91,166,934) per year. Overall costs for the vaccination program and the breakthrough RVGE cases were estimated to be 235,387,111,815 (€3,094,356,917) or 4,707,742,236 (€61,887,138) per year. From a societal perspective, universal vaccination with pentavalent rotavirus vaccine is thus expected to be a cost-saving strategy compared to no vaccination in Russia, with societal savings of 2,227,308,202 (€29,279,796) annually. Universal rotavirus vaccination with a pentavalent vaccine in Russia assuming a coverage rate similar to other vaccines included in the national immunization program is projected to reduce the number of RVGE episodes in infants over a 50-year time horizon. In light of the averted health care resource utilization and productivity costs related to RVGE as projected in this study, vaccination with a pentavalent rotavirus vaccine is a cost-saving strategy from a societal perspective compared to no vaccination.