Re-evaluation of the cost-effectiveness and effects of childhood rotavirus vaccination in Norway

• Published in: PloS one 2017-08, Vol.12 (8), p.e0183306-e0183306
• Main Authors: Hansen Edwards, Christina, de Blasio, Birgitte Freiesleben, Salamanca, Beatriz Valcárcel, Flem, Elmira
• Format: Article
• Language: English
• Subjects: Age groups; Biology and Life Sciences; Breastfeeding & lactation; Child; Child, Preschool; Childhood; Children; Children & youth; Comparative analysis; Cost analysis; Cost-Benefit Analysis; Data processing; Decision analysis; Economic aspects; Economic impact; Epidemiology; Families & family life; Health care; Health care policy; Humans; Immunization; Immunotherapy; Incidence; Infant; Infections; Infectious diseases; Medicine and Health Sciences; Mortality; Norway; Pediatrics; People and Places; Prevention; Primary care; Public health; Quality of life; Rotavirus; Rotavirus - immunology; Rotavirus infections; Rotavirus Infections - prevention & control; Sensitivity analysis; Social aspects; Studies; Utilities; Vaccination; Vaccines; Viral vaccines; Viral Vaccines - administration & dosage; Viral Vaccines - economics; Viruses
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0183306

Rotavirus vaccination was included into the Norwegian childhood immunisation programme in 2014. Before implementation, rotavirus vaccination was found to be cost-effective from a societal perspective, but not from a healthcare perspective. Since introduction, new data on the incidence and economic effects of rotavirus disease have become available. We assessed early epidemiological effects of the rotavirus vaccination programme and re-evaluated its cost-effectiveness in Norway for the years 2015-2019. Using a dynamic transmission model, we compared the epidemiological effects of the ongoing two-dose vaccination programme with Rotarix®, and a hypothetical 3-dose programme with RotaTeq® with no vaccination. A baseline cost of € 54 per fully vaccinated child was used. Cost-effectiveness was computed from a healthcare and societal perspective, using a decision analytical model. Data on healthcare use and costs, productivity losses and health utilities were based on published and own estimates. Uncertainty was accounted for in one-way, multi-way, and probabilistic sensitivity analyses. During 2015-2019, 114,658 home care cases, 34,571 primary care cases, 7,381 severe cases, and 2 deaths associated with rotavirus disease were avoided due to vaccination. Under baseline assumptions vaccination was cost-effective from a healthcare perspective with a cost per QALY of € 47,447 for Rotarix® and € 52,709 for RotaTeq®. The break-even price was € 70 for Rotarix® and € 67 for RotaTeq®. Vaccination was cost-saving from the societal perspective, and also from a healthcare perspective for vaccine prices below € 25 and € 22 per vaccinated child for Rotarix® and RotaTeq®, respectively. Ongoing childhood rotavirus vaccination in Norway has reduced the rotavirus disease burden substantially, and is cost-effective compared with no vaccination.