Economic impact of a rotavirus vaccine in Brazil.

The study was done to evaluate the cost-effectiveness of a national rotavirus vaccination programme in Brazilian children from the healthcare system perspective. A hypothetical annual birth-cohort was followed for a five-year period. Published and national administrative data were incorporated into a model to quantify the consequences of vaccination versus no vaccination. Main outcome measures included the reduction in disease burden, lives saved, and disability-adjusted life-years (DALYs) averted. A rotavirus vaccination programme in Brazil would prevent an estimated 1,804 deaths associated with gastroenteritis due to rotavirus, 91,127 hospitalizations, and 550,198 outpatient visits. Vaccination is likely to reduce 76% of the overall healthcare burden of rotavirus-associated gastroenteritis in Brazil. At a vaccine price of US$ 7-8 per dose, the cost-effectiveness ratio would be US$ 643 per DALY averted. Rotavirus vaccination can reduce the burden of gastroenteritis due to rotavirus at a reasonable cost-effectiveness ratio.

Economic and health burden of rotavirus gastroenteritis for the 2003 birth cohort in eight Latin American and Caribbean countries

OBJECTIVE: To estimate the health and economic burden of rotavirus gastroenteritis in hospital and outpatient settings in eight Latin American and Caribbean countries (Argentina, Brazil, Chile, Dominican Republic, Honduras, Mexico, Panama, and Venezuela). METHODS: An economic model was constructed using epidemiological data from published articles, national health administration studies, and country-specific cost estimates. For each of the eight countries, the model estimated the rotavirus outcomes for the 2003 birth cohort during the first five years of life. The main outcome measures included health care costs, transportation costs, lost wages, and disease burden expressed in disability-adjusted life years. Estimates were expressed in 2003 US dollars. All future costs and disability-adjusted life year estimates were discounted at a rate of 3 percent. Sensitivity analyses evaluated the impact of specific variables on the medical cost of treating rotavirus. RESULTS: For every 1 000 children born during 2003 in the eight Latin American and Caribbean countries studied here, we estimated that rotavirus gastroenteritis would result in an average of 246 outpatient visits, 24 hospitalizations, 0.6 deaths, and US$ 7 971 in direct medical costs during their first five years of life. The incidence of rotavirus-associated outpatient visits and the cost of outpatient visits were predicted to have the largest impact on the total medical cost per child. CONCLUSIONS: Rotavirus gastroenteritis is likely to result in substantial disease and economic burden to health systems in Latin American and Caribbean countries, and the foreseeable burden should be an important consideration in evaluating the cost-effectiveness of vaccination.

OBJETIVO: Estimar la carga económica y de morbilidad de la gastroenteritis por rotavirus en hospitales y servicios ambulatorios de ocho países de América Latina y el Caribe (Argentina, Brasil, Chile, Honduras, México, Panamá, República Dominicana y Venezuela). MÉTODOS: Se elaboró un modelo económico a partir de datos epidemiológicos de artículos publicados, estudios de autoridades sanitarias nacionales y los estimados de costos específicos de cada país. El modelo calculó las consecuencias de la infección por rotavirus en los primeros cinco años de vida de la cohorte de nacidos en 2003 en cada uno de los ocho países estudiados. Las principales medidas de valoración fueron los costos de la atención sanitaria, los costos de transportación, los salarios perdidos y la carga de morbilidad expresada en años de vida ajustados por discapacidad. Los estimados se expresaron en dólares estadounidenses del año 2003. Se empleó una tasa de descuento de 3 por ciento para los cálculos de costos y años de vida ajustados por discapacidad de los años siguientes. El impacto de las variables específicas sobre los costos clínicos del tratamiento de la infección por rotavirus se realizó mediante análisis de sensibilidad. RESULTADOS: Se estimó que durante los primeros cinco años de vida, la gastroenteritis por rotavirus provoca en promedio 246 consultas externas, 24 hospitalizaciones, 0,6 muertes y gastos médicos directos por US$ 7 971,00 por cada 1 000 niños nacidos en 2003 en los ocho países estudiados de América Latina y el Caribe. Se prevé que la frecuencia de visitas médicas asociadas con la infección por rotavirus y los costos por consultas externas tengan el mayor impacto en los costos clínicos totales por niño. CONCLUSIONES: La gastroenteritis por rotavirus puede representar una considerable carga económica y de morbilidad para los sistemas sanitarios de los países de América Latina y el Caribe. Se debe prestar una especial atención a la carga previsible...