Table 1

Parameters for model input
Parameter Value (95% CI) Distribution Data source Method
Total population Ineligible population Eligible population
Birth cohort (%) 182,662 168,215 (92.1%) 14,448 (7.9%) - Statistics Netherlands [46], Dutch Perinatal Registry [38], Eurocat [37] Published results on birth cohort size and prevalence of high risk conditions
RV incidence
<1 year 18,075 (11,768; 22,932) Calculated Calculated Pert Community-based cohort study [47] Incidence based on simulations from original study data updated to 2011 population size, see Mangen et al. for details [45] Distribution among eligible and ineligible based on relative size of each group in birth cohort
1 to 4 years 42,218 (24,711; 56,272)
5 to 64 years 147,997 (41,573;282,866)
5 to 9 years 6.2% of 5 to 64 years Based on age-distribution of cases 5 to 64 years in original study data
10 to 14 years 2.9% of 5–64 years
GP visits 0 to 1 years 21.2% (12.8; 26.5) Calculated Calculated Pert GP based cohort study [48] Percentage of all RV cases, based on simulations from original GP study data, see Mangen et al. for details [45]. Distribution among eligible and ineligible based on relative size of each group in birth cohort
GP visits 1 to 4 years 18.7% (16.4; 19.9)
GP visits 5 to 14 years 4.0% (1.8; 4.7)
Hospitalization (95% CI) Calculated 3,884 (3,244; 4,524) 491 (357; 626) Pert RoHo-study Weighted incidence estimation based on original study data, see Bruijning-Verhagen et al. for details [33].
Nosocomial (95% CI) Calculated 227 (162; 293) 269 (172; 365) Pert RoHo-study Weighted incidence estimation based on original study data, see Bruijning-Verhagen et al. for details [33]
Mortality rate (per 1,000 RV hospitalizations) Calculated 0.00 (0.00; 0.04) 0 81 (0.36; 1.46) Triangular RoHo study, External dataset Sophia Children’s hospital Observed mortality cases from both sources were combined for weighted mortality rate estimation
Age distribution of RV hospitalizations and fatal cases Additional file 1: Table S2 RoHo study
Utilities RV gastroenteritis QALY Loss
Mild (RV episode without medical care) 0.0011/0.002a GP study in Canada [49], Previous CEA [9] Published data
Moderate (GP visit) 0.0022/0.004a
Severe (Hospitalization) 0.0022/0.004a
Nosocomial Calculated Calculated Calculated RoHo Study Based on severity distribution of nosocomial cases observed in RoHo-study
Mortality Calculated 80.7 minus patient’s age Simulated, whereby assuming a life expectancy of 1; 20; 41.3 minus patient’s age with probability of 1/3 eachb Uniform Statistics Netherlands [46], Expert opinion For ineligible: Based on average life expectancy in the Netherlands. For eligible: Based on expert panel†
Direct healthcare costs (Euro)
Gastroenteritis episodes without medical care 0 Fixed
Standard GP visits 29 Guidelines for health-economic evaluations [39] Standard Cost Prices. See Mangen et al. for details [45]
 Home visit GP 45
 GP consultation by phone 15
 Prescriptions 40 Community-based cohort study and GP based cohort study [49,50] See Mangen et al. [45]
Laboratory costs 73
Hospitalization Calculated 2,179 (2,027;2,330) 2,550 (2,508; 3,606) Pert RoHo study Weighted estimates from original study data, see Additional file 1
Nosocomial Calculated 1,995 (1,242; 2,748) 2,129 (1,203; 3,055)
Direct non-healthcare costs
RV episode without medical care Additional diapers Uniform Assumption See Mangen et al. [45]
GP visits Additional diapers and travel costs Guidelines for health-economic evaluations [39]
Hospitalization Travel costs Pert
Nosocomial
Indirect non-healthcare costsc
Costs per hour work loss (euro) 31.11 Fixed Statistics Netherlands [48] Guidelines for health-economic evaluations [39] See Mangen et al. [45]
Hours of work loss for RV episode without medical care 0.93; 1.36; 0.84 for ages 0 to 4; 5 to 9 and 10 to 14 years respectively Uniform Community-based cohort study and GP based cohort study [49,50] Dependent of patient-age. See Mangen et al. [45]
Hours of work loss GP visits 1.35; 1.98; 1.23 for ages 0 to 4; 5 to 9 and 10 to 14 years respectively Uniform
Hours of work loss Hospitalization 37.32 hospital based observational study [51] Based on the findings from Friesema et al. [52] for children up to 18, Further details see Mangen et al. [45]
Hours of work loss Nosocomial 24.58 Based on the findings from Friesema et al. [52] for children up to 18, adjusted for excess duration of hospitalization among nosocomial in RoHo study (2.7 versus 2.9 days)
Vaccine efficacy Table 2 Vaccine trials [53-57]
Herd-immunity Universal RV vaccination Targeted RV vaccination
30% (0% to 46%) - Triangular Observational studies from US [58,59], Australia [60,61], Belgium [62] Published data
Vaccination costs
 RV1 60; 75; 90 80; 100; 120 Previous CEA [10] For Eligible: Assumption Assumed tender Price
 RV5 60; 75; 90 80; 100; 120
 Startup costs first year 218,440 -
 Application costs 6.44 See Mangen et al. [45]
 Administration costs 1.64

aincludes QALY’s lost by caretakers; ball observed fatal RV cases occurred among patients with severe congenital conditions associated with limited life-expectancy (LE). To generate valid estimates of life years lost (YLL) due to RV for each fatal case, four pediatricians (PB, MF, MvH, NH) were individually asked to provide estimates of LE without RV infection based on the patient’s medical records. Pediatricians were requested to estimate for each individual fatal RV case the probability that LE without RV would have been ≤1 year, 1 to 20, 20 to 40 years or comparable to healthy infants. Independent estimates for all seven observed cases were pooled to generate a distribution of mean YLL per fatal RV case; ccosts of third person taking care of sick child.

GP: general practitioner; QALY: quality-adjusted life years; RV: rotavirus.

Bruijning-Verhagen et al.

Bruijning-Verhagen et al. BMC Medicine 2013 11:112   doi:10.1186/1741-7015-11-112

Open Data