Open Access Highly Accessed Research article

Cost-effectiveness of rotavirus vaccination in the Netherlands; the results of a consensus model

Mark H Rozenbaum15*, Marie-Josee J Mangen2, Carlo Giaquinto3, Jan C Wilschut4, Eelko Hak1, Maarten J Postma1 and Consensus Group on Dutch Rotavirus Vaccination (CoRoVa-Group)

Author Affiliations

1 Unit of PharmacoEpidemiology & PharmacoEconomics (PE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands

2 University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands

3 Department of Paediatrics, Università degli Studi di Padova, Padova, Italy

4 Department of Medical Microbiology, Molecular Virology Section, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

5 CoRoVa = Consensus on Rotavirus Vaccination

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BMC Public Health 2011, 11:462  doi:10.1186/1471-2458-11-462

Published: 10 June 2011

Abstract

Background

Each year rotavirus gastroenteritis results in thousands of paediatric hospitalisations and primary care visits in the Netherlands. While two vaccines against rotavirus are registered, routine immunisation of infants has not yet been implemented. Existing cost-effectiveness studies showed inconsistent results for these vaccines because of lack of consensus on the impact. We aimed to investigate which factors had a major impact on cost-effectiveness and were primarily responsible for the large differences in previously estimated cost-effectiveness ratios.

Methods

Based on updated data on health outcomes and cost estimates, we re-assessed the cost-effectiveness of routine paediatric rotavirus vaccination within the National Immunization Program for the Netherlands. Two consensus meetings were organised with national and international experts in the field to achieve consensus and resolve potential controversies.

Results

It was estimated that rotavirus vaccination in the Netherlands could avert 34,214 cases of rotavirus gastroenteritis in children aged less than 5 years. Notably, 2,779 hospitalisations were averted of which 315 were extensions of existing hospital stays due to nosocomial rotavirus infection. With a threshold varying from 20K€ - 50K€ per QALY and according to the base-case scenario, the full vaccination costs per child leading to cost-effectiveness was €57.76 -€77.71. Results were sensitive to the inclusion of potential vaccine induced herd protection, QALY losses and number of deaths associated with rotavirus gastroenteritis.

Conclusions

Our economic analysis indicates that inclusion of rotavirus vaccination in the Dutch National Immunization Program might be cost-effective depending on the cost of the vaccine and the impact of rotavirus gastroenteritis on children's quality of life.