Cost-Effectiveness of Rotavirus Vaccination in France-Accounting for Indirect Protection

Dan Yamin, Katherine E Atkins, Vanessa Remy, Alison P Galvani

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Vaccination against rotavirus has shown great potential for reducing the primary cause of severe childhood gastroenteritis. Previous economic evaluations of rotavirus vaccination in France have not modeled the potential impact of vaccines on disease burden via reduced transmission.

OBJECTIVE: To determine the cost-effectiveness of the introduction of pentavalent rotavirus vaccination into the French infant vaccination schedule.

METHODS: We developed an age-structured model of rotavirus transmission calibrated to 6 years of French gastroenteritis incidence and vaccine clinical trial data. We evaluated the cost-effectiveness of pentavalent rotavirus vaccination considering that 75% of infants would receive the three-dose vaccine course.

RESULTS: Our model predicts that rotavirus vaccination will decrease rotavirus gastroenteritis incidence and associated clinical outcomes in vaccinated and unvaccinated individuals, delay the seasonal peak of infection, and increase the age of infection. From the societal perspective, our base-case scenario predicts that vaccination coverage would be cost-effective at €115 or €135 per vaccine course at €28,500 and €39,500/quality-adjusted life-year (QALY) gained, respectively, and suggests that almost 95% of the financial benefits will be recouped within the first 5 years following vaccination implementation. From the third-party payer perspective, incremental cost-effectiveness ratios ranged from €12,500 to €20,000/QALY, respectively. Our uncertainty analysis suggests that findings were sensitive to various assumptions including the number of hospitalizations, outpatient visits, and the extent of QALY losses per rotavirus episode.

CONCLUSIONS: Introducing pentavalent rotavirus vaccination into the French infant vaccination schedule would significantly reduce the burden of rotavirus disease in children, and could be cost-effective under plausible conditions.

Original languageEnglish
Pages (from-to)811-819
Number of pages9
JournalValue in Health
Volume19
Issue number6
Early online date15 Jul 2016
DOIs
Publication statusPublished - 8 Oct 2016

Keywords

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Cost-Benefit Analysis
  • France
  • Humans
  • Immunization Schedule
  • Infant
  • Infant, Newborn
  • Middle Aged
  • Models, Theoretical
  • Quality of Life
  • Rotavirus Infections/prevention & control
  • Rotavirus Vaccines/economics
  • Vaccination/economics
  • Young Adult

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