Cost-effectiveness of rotavirus vaccination in peru.


Clark, AD; Walker, DG; Mosqueira, NR; Penny, ME; Lanata, CF; Fox-Rushby, J; Sanderson, CF; (2009) Cost-effectiveness of rotavirus vaccination in peru. The Journal of infectious diseases, 200 Suppl 1. S114-24. ISSN 0022-1899 DOI: 10.1086/605043

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Abstract

BACKGROUND: There are plans to introduce the oral rotavirus vaccine Rotarix (GlaxoSmithKline), 1 of 2 recently developed vaccines against rotavirus, in Peru. METHODS: We modeled the cost-effectiveness of adding a rotavirus vaccine to the Peruvian immunization program under 3 scenarios for the timing of vaccination: (1) strictly according to schedule, at 2 and 4 months of age (on time); (2) distributed around the target ages in the same way as the actual timings in the program (flexible); and (3) flexible but assuming vaccination is not initiated for infants >12 weeks of age (restricted). We assumed an introductory price of US $7.50 per dose, and varied the annual rate of price decrease in sensitivity analyses. RESULTS: The discounted cost per disability-adjusted life-year averted for restricted, flexible, and on-time schedules was $621, $615, and $581, respectively. For each of the 3 scenarios, the percentage reduction in deaths due to rotavirus infection was 53%, 66%, and 69%, respectively. The cost per disability-adjusted life-year averted for alternative "what-if" scenarios ranged from $229 (assuming a 1-dose schedule, administered on time) to $1491 (assuming a 2-dose schedule, with half the baseline vaccine efficacy rates and a restricted timing policy). CONCLUSIONS: On the basis of current World Health Organization guidelines, rotavirus vaccination represents a highly cost-effective intervention in Peru. Withholding the vaccine from children who present for their first dose after 12 weeks of age would reduce the number of deaths averted by approximately 20%. A single dose may be more cost-effective than 2 doses, but more evidence on the protection conferred by a single dose is required.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Global Health and Development
Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Research Centre: Vaccine Centre
PubMed ID: 19817591
Web of Science ID: 270655100015
URI: http://researchonline.lshtm.ac.uk/id/eprint/3714

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