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Costs of Diarrheal Disease and the Cost‐Effectiveness of a Rotavirus Vaccination Program in Kyrgyzstan

Elmira FlemDivision of Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway. [email protected]Renat LatipovZuridin Sharipovich NurmatovDepartment of State Sanitary-Epidemiologic Surveillance, Ministry of Health, Bishkek, Kyrgyz Republic; andYiting XueDepartment of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway;Kaliya KasymbekovaDepartment of State Sanitary-Epidemiologic Surveillance, Ministry of Health, Bishkek, Kyrgyz Republic; andRichard RheingansDepartment of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
2009en
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Аннотация

INTRODUCTION: We examined the cost-effectiveness of a rotavirus immunization program in Kyrgyzstan, a country eligible for vaccine funding from the GAVI Alliance. METHODS: We estimated the burden of rotavirus disease and its economic consequences by using national and international data. A cost-effectiveness analysis was conducted from government and societal perspectives, along with a range of 1-way sensitivity analyses. RESULTS: Rotavirus-related hospitalizations and outpatient visits cost US$580,864 annually, of which $421,658 (73%) is direct medical costs and $159,206 (27%) is nonmedical and indirect costs. With 95% coverage, vaccination could prevent 75% of rotavirus-related hospitalizations and deaths and 56% of outpatient visits and could avert $386,193 (66%) in total costs annually. The medical break-even price at which averted direct medical costs equal vaccination costs is $0.65/dose; the societal break-even price is $1.14/dose for a 2-dose regimen. At the current GAVI Alliance-subsidized vaccine price of $0.60/course, rotavirus vaccination is cost-saving for the government. Vaccination is cost-effective at a vaccine price $9.41/dose, according to the cost-effectiveness standard set by the 2002 World Health Report. CONCLUSIONS: Addition of rotavirus vaccines to childhood immunization in Kyrgyzstan could substantially reduce disease burden and associated costs. Vaccination would be cost-effective from the national perspective at a vaccine price $9.41 per dose.

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