Cost and cost-effectiveness of childhood vaccination against rotavirus in France.
OBJECTIVE
To assess the effectiveness and cost-effectiveness of routine childhood vaccination by new vaccines against rotavirus in France.


METHODS
We constructed a Markov decision tree to compare two alternatives: "no vaccination" and "vaccination". A hypothetical birth cohort of 750,000 children was followed until 3 years of age. First, the disease burden without vaccine was estimated using data from French databases and medical literature. Incidence rates in unvaccinated children were modelled as a function of age and seasons. Next, using data from the medical literature, the vaccine's protective effect on rotavirus diarrhoea was considered.


RESULTS
A routine universal rotavirus immunization programme was estimated capable of annually avoiding 89,000 cases of diarrhoea, 10,500 hospitalizations, and 8 deaths. At a vaccination cost of euro 150/course, assuming 75% vaccine coverage, the programme would cost euro 95 million and involve a net loss of euro 68 million to the health care system. The vaccination programme would cost euro 298,000/year of life saved, and euro 138,000/QALY saved. Key variables affecting the results were disease incidence, mortality rates and vaccine price.


CONCLUSIONS
In France, childhood rotavirus vaccination with new anti-rotavirus vaccines would reduce the morbidity burden of rotavirus infection, but would not be cost-effective unless the price of vaccine decreased considerably.
Melliez
H
H
Service Universitaire des Maladies Infectieuses et du Voyageur, Centre Hospitalier de Tourcoing, France. hugues.melliez@orange.fr <hugues.melliez@orange.fr>
Levybruhl
D
D
Boelle
P Y
PY
Dervaux
B
B
Baron
S
S
Yazdanpanah
Y
Y
D002648:Child; D002675:Child, Preschool; D003132:Commerce; D003362:Cost-Benefit Analysis; D005602:France / Q000453:epidemiology; D017048:Health Care Costs; D006801:Humans; D017589:Immunization Programs / Q000191:economics; D007223:Infant; D008390:Markov Chains; D008962:Models, Theoretical; D012401:Rotavirus; D012400:Rotavirus Infections / Q000191:economics* / Q000276:immunology* / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000191:economics*; D014611:Vaccination
D022243:Rotavirus Vaccines