Revisión sistemática de estudios de evaluación económica sobre vacunas antirrotavirus

Abstract

ObjectiveTo establish a range of prices and outcomes of rotavirus vaccines in order to help decision-making on universal vaccination in health systems. DesignSystematic review of reported economic analyses of rotavirus vaccines. MethodsElectronic searches in MEDline, EMBASE, Cochrane Library, DARE and Euronheed. Inclusion criteria were cost-effectiveness, cost-utility, and cost-benefit analyses in healthy children. Interventions considered were rotavirus vaccination programmes in neonates versus no vaccination programmes. Main outcomes were cost per year of live gained, cost per QALY, cost per DALY, and net costbenefit. Secondary outcomes were clinical resources avoided (consults, hospitalizations, urgent visits) and their associated costs. The quality of the studies included was measured by the CASPe checklist. Results163 references were found. After selecting by title and abstract, we selected 14 studies. The general quality was high.We included 1 review, 9 cost-utility analyses, 2 cost-effectiveness analyses, and 2 cost-benefit analyses. Studies simulated a cohort of neonates who were vaccinated with coverages between 65 and 100%. The sensibility analysis showed the results varied widely according to assumptions about the mortality rate, vaccine cost and vaccine effectiveness. The value range for QALY was 21.900 € to 155.077 € and the range for DALY was 34,25 € to 164.386 €. ConclusionsThe variability in the results, together with the vaccine cost, meant the cost-effectiveness was substantially influenced by the assumptions of the models and that vaccination could be expensive for the health system. Decision-making on rotavirus vaccination should be guided by other aspects in addition those studied here.