title: Projected impact and cost-effectiveness of a rotavirus vaccination program in India, 2008.
abstract: BACKGROUND
  To assess the value of rotavirus vaccination in India, we determined the potential impact and cost-effectiveness of a national rotavirus vaccination program.
  
  
  METHODS
  We compared the national rotavirus disease and cost burden with and without a vaccination program and assessed the cost-effectiveness of vaccination. Model inputs included measures of disease and cost burden, vaccine performance, and vaccination coverage and cost. We measured the annual number of health-related events and treatment costs averted, as well as the cost-effectiveness in US dollars per disability-adjusted life-year (DALY) and cost per death averted. One-way sensitivity analyses were performed by individually varying each model input.
  
  
  RESULTS
  With use of a vaccine that has an estimated effectiveness of 50%, a rotavirus vaccination program in India would prevent ~44,000 deaths, ~293,000 hospitalizations, and ~328,000 outpatient visits annually, which would avert $20.6 million in medical treatment costs. Vaccination would be cost-saving at the GAVI Alliance price of $0.15 per dose. At $1.00 per dose, a vaccination program would cost $49.8 million, which would result in an expenditure of $21.41 per DALY averted or $662.94 per life saved. Even at $7.00 per dose, vaccination would be highly cost-effective. In sensitivity analyses, varying efficacy against severe rotavirus disease and vaccine price had the greatest impact on cost-effectiveness.
  
  
  CONCLUSIONS
  A national rotavirus vaccination program in India would prevent substantial rotavirus morbidity and mortality and would be highly cost-effective at a range of vaccine prices. Public health officials can use this locally derived data to evaluate how this highly cost-effective intervention might fit into India's long-term health care goals.
authors.affiliation: Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clinton Rd. NE, Atlanta, GA 30333, USA. hgj4@cdc.gov
authors.forename: Douglas H
authors.initials: DH
authors.lastname: Esposito
authors.forename: Jacqueline E
authors.initials: JE
authors.lastname: Tate
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kang
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
mesh_terms: D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D015233:Models, Statistical; D012400:Rotavirus Infections / Q000191:economics* / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000191:economics* / Q000276:immunology*; D014611:Vaccination / Q000191:economics* / Q000379:methods*
chemical_list: D022243:Rotavirus Vaccines