Impact and cost-effectiveness of rotavirus vaccination in Bangladesh

Details

• Alternative Title:
  Vaccine
• Personal Author:
  Pecenka, Clint ; Parashar, Umesh ; Tate, Jacqueline E. ; Khan, Jahangir A.M. ; Groman, Devin ; Chacko, Stephen ; Shamsuzzaman, Md ; Clark, Andrew ; Atherly, Deborah
• Description:
  Introduction
  
  Diarrheal disease is a leading cause of child mortality globally, and rotavirus is responsible for more than a third of those deaths. Despite substantial decreases, the number of rotavirus deaths in children under five was 215,000 per year in 2013. Of these deaths, approximately 41% occurred in Asia and 3% of those in Bangladesh. While Bangladesh has yet to introduce rotavirus vaccination, the country applied for Gavi support and plans to introduce it in 2018. This analysis evaluates the impact and cost-effectiveness of rotavirus vaccination in Bangladesh and provides estimates of the costs of the vaccination program to help inform decision-makers and international partners.
  
  Methods
  
  This analysis used Pan American Health Organization’s TRIVAC model (version 2.0) to examine nationwide introduction of two-dose rotavirus vaccination in 2017, compared to no vaccination. Three mortality scenarios (low, high, and midpoint) were assessed. Benefits and costs were examined from the societal perspective over ten successive birth cohorts with a 3% discount rate. Model inputs were locally acquired and complemented by internationally validated estimates.
  
  Results
  
  Over ten years, rotavirus vaccination would prevent 4000 deaths, nearly 500,000 hospitalizations and 3 million outpatient visits in the base scenario. With a Gavi subsidy, cost/disability adjusted life year (DALY) ratios ranged from $58/DALY to $142/DALY averted. Without a Gavi subsidy and a vaccine price of $2.19 per dose, cost/DALY ratios ranged from $615/DALY to $1514/DALY averted.
  
  Conclusion
  
  The discounted cost per DALY averted was less than the GDP per capita for nearly all scenarios considered, indicating that a routine rotavirus vaccination program is highly likely to be cost-effective. Even in a low mortality setting with no Gavi subsidy, rotavirus vaccination would be cost-effective. These estimates exclude the herd immunity benefits of vaccination, so represent a conservative estimate of the cost-effectiveness of rotavirus vaccination in Bangladesh.
  
  
• Subjects:
  Article Child, Preschool Cohort Studies Cost-Benefit Analysis Female Humans Infant Infant, Newborn Male Rotavirus Infections/economics Rotavirus Infections/epidemiology Rotavirus Infections/prevention & Control Rotavirus Vaccines/administration & Dosage Rotavirus Vaccines/economics Survival Analysis Vaccination/economics

  More +
• Source:
  Vaccine. 2017; 35(32):3982-3987.
• Pubmed ID:
  28623028
• Pubmed Central ID:
  PMC5512265
• Document Type:
  Journal Article
• Place as Subject:
  Bangladesh
• Volume:
  35
• Issue:
  32
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:433ce455f852821526cbef0dfc202922a7f8dfc02d7ea790f1014a97d9889644
• Download URL:
  https://stacks.cdc.gov/view/cdc/46943/cdc_46943_DS1.pdf
• File Type:
  [PDF - 653.90 KB ]