COST-EFFECTIVENESS ANALYSIS OF A ROTAVIRUS IMMUNIZATION PROGRAM FOR THE UNITED-STATES

Objective. To estimate the economic consequences in the United States of routine childhood immunization of children younger than 1 year of a ge with a rotavirus (RV) vaccine. Design. Cost-effectiveness analysis of a national RV immunization program from the perspective of the heal th care system and the perspective of society. Estimates of disease in cidence, medical expenditures, productivity costs, vaccine efficacy, a nd vaccine coverage rates were derived from published literature and u npublished vaccine trial reports. The impact of changes in estimates o f vaccine efficacy and medical costs was determined by sensitivity ana lysis. Main Outcome Measures. Incremental cost effectiveness, expresse d as savings per case of RV diarrhea prevented. Results. Given a vacci ne efficacy rate of 50% and a vaccine cost of $30 per dose, an RV immu nization program would prevent more than 1 million eases of RV diarrhe a, 58 000 hospitalizations, and 82 deaths per year. A vaccine program would cost $243 million per year but would yield net savings of $79 mi llion from the perspective of the health care system and $466 million from the perspective of society. The incremental cost effectiveness wa s a savings of $459 per case prevented from the societal perspective a nd $78 per case prevented from the health care system perspective. Sen sitivity analyses substantiated net savings over a wide range of varia bles, and cost effectiveness increased with greater vaccine efficacy o r decreased vaccine cost. Conclusions. Economic and disease reduction benefits would be realized from the use of an RV vaccine that is parti ally protective against severe RV diarrhea. These findings suggest tha t immunization with an RV vaccine would be cost effective and cost sav ing.