A cost-effectiveness analysis on universal infant rotavirus vaccination strategy in China / 中华流行病学杂志

ABSTRACT

Objective To evaluate the cost-effectiveness of current universal infant rotavirus vaccination strategy,in China.Methods Through constructing decision tree-Markov model,we simulated rotavirus diarrhea associated cost and health outcome on those newborns in 2012 regarding different vaccination programs asgroup with no vaccination,Rotavirus vaccination group and Rotateq vaccination group,respectively.We determined the optimal program,based on the comparison between incremental cost-effectiveness ratio (ICER) and China' s 2012 per capital gross domestic product (GDP).Results Compared with non-vaccination group,the Rotavirus vaccination and Rotateq vaccination groups had to pay 3 760 Yuan and 7 578 Yuan (both less than 2012 GDP per capital) to avert one disability adjusted life years (DALY) loss,respectively.Results from sensitivity analysis indicated that both results were robust.Compared with Rotavirus vaccination program,the Rotateq vaccination program had to pay extra 81 068 Yuan (between 1 and 3 times GDP per capital) to avert one DALY loss.Data from the sensitivity analysis indicated that the result was not robust.Conclusion From the perspective of health economics,both two-dose Rotarix vaccine and three-dose's Rotateq vaccine programs were highly cost-effective,when compared to the non-vaccination program.It was appropriate to integrate rotavirus vaccine into the routine immunization program.Considering the large amount of extra cost that had to spend on Rotateq vaccination program,results from the sensitivity analysis showed that it was not robust.Rotateq vaccine required one more dose than the Rotarix vaccine,to be effective.However,it appeared more difficult to practice,suggesting that it was better to choose the Rotarix vaccine,at current stage.