INTRODUCTION: Rotavirus is the main cause of gastroenteritis in Canadian children younger than five years of age, resulting in significant morbidity and cost. The present study provides evidence on the cost effectiveness of two alternative rotavirus vaccinations (RotaTeq [Merck Frosst Canada Ltd, Canada] and Rotarix [GlaxoSmithKline, Canada]) available in Canada.METHODS: Analysis was conducted through a Markov model that followed a cohort of children from birth to five years of age. Analysis used pertinent data on the natural history of rotavirus and the effects of vaccination. Estimates of heath care costs for children requiring hospitalizations and emergency department visits were derived from the Canadian Immunization Monitoring Program, Active (IMPACT) surveillance, emergency department studies, as well as other Canadian studies. The model estimated the effect of vaccination on costs and quality-adjusted life years (QALYs).RESULTS: The incremental cost per QALY gained from the health care system perspective was $122,000 for RotaTeq and $108,000 for Rotarix. From the societal perspective, both vaccination strategies were dominant – both cost saving and more effective. The cost-effectiveness of vaccination is dependent on the mode of administration, the perspective adopted and the cost of the vaccine.CONCLUSIONS: From a societal perspective, a universal vaccination program against rotavirus will be both cost saving and more effective than no vaccination. Becasue the majority of rotavirus infections do not require emergency department visits or hospital admission, from a health care system perspective, a program would not be considered cost effective.

中文翻译：

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加拿大婴儿轮状病毒疫苗接种的成本效益。

简介：轮状病毒是加拿大 5 岁以下儿童肠胃炎的主要原因，导致显着的发病率和费用。本研究为加拿大提供的两种替代轮状病毒疫苗（RotaTeq [Merck Frosst Canada Ltd, Canada] 和 Rotarix [GlaxoSmithKline, Canada]）的成本效益提供证据。儿童从出生到五岁。分析使用了有关轮状病毒自然史和疫苗接种效果的相关数据。需要住院和急诊科就诊的儿童的保健费用估计数来自加拿大免疫监测计划、主动 (IMPACT) 监测、急诊科研究以及其他加拿大研究。该模型估计了疫苗接种对成本和质量调整生命年 (QALY) 的影响。结果：从医疗保健系统的角度来看，每个 QALY 的增量成本为 RotaTeq 为 122,000 美元，Rotarix 为 108,000 美元。从社会角度来看，两种疫苗接种策略都占主导地位——既节省成本又更有效。疫苗接种的成本效益取决于接种方式、采用的观点和疫苗的成本。结论：从社会角度来看，针对轮状病毒的通用疫苗接种计划将既节省成本又比不接种疫苗更有效。由于大多数轮状病毒感染不需要急诊就诊或住院，因此从医疗保健系统的角度来看，该计划不会被认为具有成本效益。