title: Estimating and comparing the clinical and economic impact of paediatric rotavirus vaccination in Turkey using a simple versus an advanced model.
abstract: BACKGROUND
  The burden of rotavirus disease is high in Turkey, reflecting the large birth cohort (>1.2 million) and the risk of disease. Modelling can help to assess the potential economic impact of vaccination. We compared the output of an advanced model with a simple model requiring fewer data inputs. If the results are similar, this could be helpful for countries that have few data available.
  
  
  METHODS
  The advanced model was a previously published static Markov cohort model comparing costs and quality-adjusted life-year (QALY) outcomes of vaccination versus no vaccination. In contrast, the simple model used only a decision tree. Both models included data on demography, epidemiology, vaccine efficacy, resource use, unit costs, and utility scores from national databases and published papers. Only the perspective of the health care payer was considered in the analysis. The simple model had 23 variables, compared with 103 in the advanced model to allow additional comparisons of different vaccine types, dose schemes and vaccine waning.
  
  
  RESULTS
  With the same input data, both models showed that rotavirus vaccination in Turkey would improve health outcomes (fewer QALYs lost to rotavirus disease). The projected annual cost offsets were $29.9 million in the simple and $29.4 million in the advanced model. Sensitivity analysis indicated that in both models the main cost driver was disease incidence followed by cost for hospital care and medical visits. Vaccine efficacy had a smaller effect.
  
  
  CONCLUSIONS
  Both models reached similar conclusions. Both projected that rotavirus vaccination in Turkey would improve health outcomes and may result in savings in direct healthcare costs to offset the cost of vaccination. The analysis indicated that the simple model can produce meaningful economic results in conditions where few data are available.
authors.affiliation: Division of Paediatric Infectious Diseases, Department of Paediatrics, Marmara University School of Medicine, Pendik, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Bakir
authors.forename: Baudouin
authors.initials: B
authors.lastname: Standaert
authors.forename: Ozden
authors.initials: O
authors.lastname: Turel
authors.forename: Zeynep Ece
authors.initials: ZE
authors.lastname: Bilge
authors.forename: Maarten
authors.initials: M
authors.lastname: Postma
mesh_terms: D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis / Q000379:methods; D004812:Epidemiologic Methods; D006801:Humans; D007223:Infant; D015233:Models, Statistical; D012400:Rotavirus Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000008:administration & dosage* / Q000191:economics* / Q000276:immunology; D014421:Turkey / Q000453:epidemiology; D014611:Vaccination / Q000191:economics* / Q000706:statistics & numerical data*
chemical_list: D022243:Rotavirus Vaccines