title: Cost effectiveness of infant vaccination for rotavirus in Canada.
abstract: BACKGROUND
  Rotavirus is the main cause of gastroenteritis in Canadian children younger than five years of age, resulting in significant morbidity and cost. The present study provides evidence on the cost effectiveness of two alternative rotavirus vaccinations (RotaTeq [Merck Frosst Canada Ltd, Canada] and Rotarix [GlaxoSmithKline, Canada]) available in Canada.
  
  
  METHODS
  Analysis was conducted through a Markov model that followed a cohort of children from birth to five years of age. Analysis used pertinent data on the natural history of rotavirus and the effects of vaccination. Estimates of heath care costs for children requiring hospitalizations and emergency department visits were derived from the Canadian Immunization Monitoring Program, Active (IMPACT) surveillance, emergency department studies, as well as other Canadian studies. The model estimated the effect of vaccination on costs and quality-adjusted life years (QALYs).
  
  
  RESULTS
  The incremental cost per QALY gained from the health care system perspective was $122,000 for RotaTeq and $108,000 for Rotarix. From the societal perspective, both vaccination strategies were dominant - both cost saving and more effective. The cost-effectiveness of vaccination is dependent on the mode of administration, the perspective adopted and the cost of the vaccine.
  
  
  CONCLUSIONS
  From a societal perspective, a universal vaccination program against rotavirus will be both cost saving and more effective than no vaccination. Becasue the majority of rotavirus infections do not require emergency department visits or hospital admission, from a health care system perspective, a program would not be considered cost effective.
authors.affiliation: Department of Epidemiology and Community Medicine, University of Ottawa;
authors.forename: Doug
authors.initials: D
authors.lastname: Coyle
authors.forename: Kathryn
authors.initials: K
authors.lastname: Coyle
authors.forename: Julie A
authors.initials: JA
authors.lastname: Bettinger
authors.forename: Scott A
authors.initials: SA
authors.lastname: Halperin
authors.forename: Wendy
authors.initials: W
authors.lastname: Vaudry
authors.forename: David W
authors.initials: DW
authors.lastname: Scheifele
authors.forename: Nicole
authors.initials: N
authors.lastname: Le Saux
keywords: Cost effectiveness; Rotavirus; Vaccination