ABSTRACT

Introduction

World Health Organization recommends rotavirus vaccine for all national immunization programs (NIPs). To provide country-specific evidence, we conducted economic evaluation of a monovalent rotavirus vaccination using specific data of the pilot phase in Thailand.

Method

A Markov model was adopted to compare the 2020 birth cohort once receiving rotavirus vaccination versus no vaccination from healthcare and societal perspective over five years. Data on disease burden, vaccine effectiveness, costs, and utilities were taken from a cohort study in two provinces of Thailand. Sensitivity analyses were performed to test the robustness of the results.

Results

Rotavirus vaccination would reduce rotavirus diarrhea and costs of illness by 48% and 71%, respectively, over the first five years of life. At USD 13 per dose, vaccine was cost-effective with the ICERs of USD 4,114 and USD 1,571per QALY gained from healthcare and societal perspective, respectively. Results were sensitive to incidence and vaccine cost. The budget for vaccine purchasing was estimated at USD13 million per year.

Conclusion

Incorporating rotavirus vaccination into the NIP substantially reduced health and cost outcomes and was cost-effective for both perspectives. However, the government needs to negotiate vaccine price prior to program implementation to achieve favorable budget impact.

中文翻译：

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轮状病毒疫苗接种的经济评价：泰国引入国家免疫计划的重要一步

摘要

介绍

世界卫生组织建议为所有国家免疫计划 (NIP) 接种轮状病毒疫苗。为了提供特定国家的证据，我们使用泰国试点阶段的特定数据对单价轮状病毒疫苗接种进行了经济评估。

方法

采用马尔可夫模型比较了 2020 年出生队列接受轮状病毒疫苗接种与五年内从医疗保健和社会角度未接种疫苗的情况。有关疾病负担、疫苗有效性、成本和效用的数据来自泰国两个省的队列研究。进行敏感性分析以测试结果的稳健性。

结果

在生命的前五年，轮状病毒疫苗接种将分别减少 48% 和 71% 的轮状病毒腹泻和疾病费用。每剂 13 美元的疫苗具有成本效益，从医疗保健和社会角度来看，每 QALY 的 ICER 分别为 4,114 美元和 1,571 美元。结果对发病率和疫苗成本很敏感。疫苗采购预算估计为每年 1300 万美元。

结论

将轮状病毒疫苗纳入 NIP 大大降低了健康和成本结果，并且从两个角度来看都是具有成本效益的。但是，政府需要在计划实施之前就疫苗价格进行谈判，以实现有利的预算影响。