Evaluating the potential economic and health impact of rotavirus vaccination in 63 middle-income countries not eligible for Gavi funding: a modelling study
| Autor: | Clint Pecenka, Jacqueline E. Tate, Andrew Clark, Ranju Baral, Umesh D. Parashar, Frédéric Debellut, Deborah Atherly, Colin Sanderson |
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| Rok vydání: | 2021 |
| Předmět: |
Rotavirus
Age structure Cost-Benefit Analysis Uncertainty interval 030231 tropical medicine Health impact Rotavirus gastroenteritis medicine.disease_cause Rotavirus vaccination Risk Assessment Rotavirus Infections 03 medical and health sciences 0302 clinical medicine Environmental health medicine Humans 030212 general & internal medicine Developing Countries health care economics and organizations business.industry Vaccination Comment Middle income countries Rotavirus Vaccines Infant Articles General Medicine Models Theoretical Child Preschool Public aspects of medicine RA1-1270 business |
| Zdroj: | The Lancet Global Health, Vol 9, Iss 7, Pp e942-e956 (2021) The Lancet. Global Health |
| ISSN: | 2214-109X |
| DOI: | 10.1016/s2214-109x(21)00167-4 |
| Popis: | Summary Background Middle-income countries (MICs) that are not eligible for funding from Gavi, the Vaccine Alliance, have been slow to adopt rotavirus vaccines. Few studies have evaluated the cost-effectiveness and benefit–risk of rotavirus vaccination in these settings. We aimed to assess the potential economic and health impact of rotavirus vaccination in 63 MICs not eligible for funding from Gavi. Methods In this modelling study, we estimated the cost-effectiveness and benefit–risk of rotavirus vaccination in 63 MICs not eligible to Gavi funding. We used an Excel-based proportionate outcomes model with a finely disaggregated age structure to estimate the number of rotavirus gastroenteritis cases, clinic visits, hospitalisations, and deaths averted by vaccination in children younger than 5 years over a 10-year period. We calculated cost-effectiveness ratios (costs per disability-adjusted life-years averted compared with no vaccination) and benefit–risk ratios (number of hospitalisations due to rotavirus gastroenteritis averted per excess hospitalisations due to intussusception). We evaluated three alternative vaccines available globally (Rotarix, Rotavac, and Rotasiil) and used information from vaccine manufacturers regarding anticipated vaccine prices. We ran deterministic and probabilistic uncertainty analyses. Findings Over the period 2020–29, rotavirus vaccines could avert 77 million (95% uncertainty interval [UI] 51–103) cases of rotavirus gastroenteritis and 21 million (12–36) clinic visits, 3 million (1·4–5·6) hospitalisations, and 37 900 (25 900–55 900) deaths due to rotavirus gastroenteritis in 63 MICs not eligible for Gavi support. From a government perspective, rotavirus vaccination would be cost-effective in 48 (77%) of 62 MICs considered. The benefit–risk ratio for hospitalisations prevented versus those potentially caused by vaccination exceeded 250:1 in all countries. Interpretation In most MICs not eligible for Gavi funding, rotavirus vaccination has high probability to be cost-effective with a favourable benefit–risk profile. Policy makers should consider this new evidence when making or revisiting decisions on the use of rotavirus vaccines in their respective countries. Funding Bill & Melinda Gates Foundation. |
| Databáze: | OpenAIRE |
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