Projected cost-effectiveness of rotavirus vaccination for children in Asia.
BACKGROUND
New rotavirus vaccines may soon be licensed, and decisions regarding implementation of their use will likely be based on the health and economic benefits of vaccination.


METHODS
We estimated the benefits and cost-effectiveness of rotavirus vaccination in Asia by using published estimates of rotavirus disease incidence, health care expenditures, vaccine coverage rates, and vaccine efficacy.


RESULTS
Without a rotavirus vaccination program, it is estimated that 171,000 Asian children will die of rotavirus diarrhea, 1.9 million will be hospitalized, and 13.5 million will require an outpatient visit by the time the Asian birth cohort reaches 5 years of age. The medical costs associated with these events are approximately 191 million US dollars; however, the total burden would be higher with the inclusion of such societal costs as lost productivity. A universal rotavirus vaccination program could avert approximately 109,000 deaths, 1.4 million hospitalizations, and 7.7 million outpatient visits among these children.


CONCLUSIONS
A rotavirus vaccine could be cost-effective, depending on the income level of the country, the price of the vaccine, and the cost-effectiveness standard that is used. Decisions regarding implementation of vaccine use should be based not only on whether the intervention provides a cost savings but, also, on the value of preventing rotavirus disease-associated morbidity and mortality, particularly in countries with a low income level (according to 2004 World Bank criteria for the classification of countries into income groups on the basis of per capita gross national income) where the disease burden is great.
Podewils
Laura Jean
LJ
Respiratory and Enteric Viruses Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. lpp8@cdc.gov
Antil
Lynn
L
Hummelman
Erik
E
Bresee
Joseph
J
Parashar
Umesh D
UD
Rheingans
Richard
R
D001208:Asia / Q000453:epidemiology; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003967:Diarrhea / Q000191:economics / Q000401:mortality / Q000517:prevention & control; D004469:Economics, Hospital; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D010045:Outpatients; D010343:Patient Admission / Q000191:economics; D011446:Prospective Studies; D012400:Rotavirus Infections / Q000191:economics* / Q000401:mortality / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000191:economics*; D014611:Vaccination / Q000191:economics*
D022243:Rotavirus Vaccines