Economic evaluation of the introduction of rotavirus vaccine in Hong Kong |
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Authors: | Karene Hoi Ting Yeung Shi Lin Lin Andrew Clark Sarah M McGhee Cara Bess Janusz Deborah Atherly Kate C Chan E Anthony S Nelson |
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Institution: | 1. Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong;2. Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom;3. School of Public Health, The University of Hong Kong, Hong Kong;4. PAHO ProVac Initiative, Pan American Health Organization, Washington, DC, United States;5. Center for Vaccine Innovation and Access, PATH, Seattle, United States |
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Abstract: | BackgroundRotavirus is a common cause of severe gastroenteritis in young children in Hong Kong (HK) with a high economic burden. This study aimed to evaluate the cost-effectiveness of introducing rotavirus vaccination into the HK Government’s Childhood Immunisation Programme (CIP) and to include the potential protective effect of the vaccine against seizures.MethodsA decision-support model was customised to estimate the potential impact, cost-effectiveness and benefit-risk of rotavirus vaccination in children below 5 years over the period 2020–2029 in HK. Two doses of Rotarix® and three doses of RotaTeq® were each compared to no vaccination. Rotavirus treatment costs were calculated from a governmental health sector perspective (i.e., costs of public sector treatment) and an overall health sector perspective (both governmental and patient, i.e., costs of public sector treatment, private sector treatment, transport and diapers). We ran probabilistic and deterministic uncertainty analyses.ResultsIntroduction of rotavirus vaccination in HK could prevent 49,000 (95% uncertainty interval: ~44,000–54,000) hospitalisations of rotavirus gastroenteritis and seizures and result in ~50 (95% uncertainty interval: ~25–85) intussusception hospitalisations, over the period 2020–2029 (a benefit-risk ratio of ~1000:1), compared to a scenario with no public or private sector vaccine use. The discounted vaccination cost would be US$51–57 million over the period 2020–2029 based on per-course prices of US$72 (Rotarix®) or US$78 (RotaTeq®), but this would be offset by discounted treatment cost savings of US$70 million (government) and US$127 million (governmental and patient health sector). There was a greater than 94% probability that the vaccine could be cost-saving irrespective of the vaccine product or perspective considered. All deterministic ‘what-if’ scenarios were cost-saving from an overall health sector perspective (governmental and patient).ConclusionsRotavirus vaccination is likely to be cost-saving and have a favourable benefit-risk profile in HK. Based on the assumptions made, our analysis supports its introduction into CIP. |
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Keywords: | Rotavirus Rotavirus vaccine Economic evaluation Cost-effectiveness Hong Kong Paediatrics A&E"} {"#name":"keyword" "$":{"id":"k0040"} "$$":[{"#name":"text" "_":"Accident and Emergency CFRs"} {"#name":"keyword" "$":{"id":"k0050"} "$$":[{"#name":"text" "_":"case-fatality ratios CIP"} {"#name":"keyword" "$":{"id":"k0060"} "$$":[{"#name":"text" "_":"Childhood Immunisation Programme CMS"} {"#name":"keyword" "$":{"id":"k0070"} "$$":[{"#name":"text" "_":"Clinical Management System DALY"} {"#name":"keyword" "$":{"id":"k0080"} "$$":[{"#name":"text" "_":"disability-adjusted life-year DH"} {"#name":"keyword" "$":{"id":"k0090"} "$$":[{"#name":"text" "_":"Department of Health DTP"} {"#name":"keyword" "$":{"id":"k0100"} "$$":[{"#name":"text" "_":"Diphtheria-Tetanus-Pertussis GDP"} {"#name":"keyword" "$":{"id":"k0110"} "$$":[{"#name":"text" "_":"Gross Domestic Product HA"} {"#name":"keyword" "$":{"id":"k0120"} "$$":[{"#name":"text" "_":"Hospital Authority HIC"} {"#name":"keyword" "$":{"id":"k0130"} "$$":[{"#name":"text" "_":"high-income country LIC"} {"#name":"keyword" "$":{"id":"k0140"} "$$":[{"#name":"text" "_":"lower-income country LMIC"} {"#name":"keyword" "$":{"id":"k0150"} "$$":[{"#name":"text" "_":"lower-middle-income country MCHC"} {"#name":"keyword" "$":{"id":"k0160"} "$$":[{"#name":"text" "_":"Maternal and Child Health Centre PCV"} {"#name":"keyword" "$":{"id":"k0170"} "$$":[{"#name":"text" "_":"pneumococcal conjugate vaccine QALY"} {"#name":"keyword" "$":{"id":"k0180"} "$$":[{"#name":"text" "_":"quality-adjusted life year RVGE"} {"#name":"keyword" "$":{"id":"k0190"} "$$":[{"#name":"text" "_":"rotavirus gastroenteritis UI"} {"#name":"keyword" "$":{"id":"k0200"} "$$":[{"#name":"text" "_":"uncertainty interval WHO"} {"#name":"keyword" "$":{"id":"k0210"} "$$":[{"#name":"text" "_":"World Health Organization |
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