Cost-effectiveness of rotavirus vaccination programs in Taiwan.
BACKGROUND
In Taiwan, two rotavirus vaccines are available on the private market, but are not included in the National Immunization Program (NIP). To help assess whether to include rotavirus vaccines in the NIP, we examined the potential impact and cost-effectiveness of vaccination, from the health care system perspective alone.


METHODS
We used a Microsoft Excel-based model to assess rotavirus vaccination impact on rotavirus disease burden and the cost-effectiveness of 2-dose and 3-dose vaccination programs among a birth cohort of Taiwanese children followed for 5 years. Principal model inputs included data on rotavirus disease burden and related healthcare costs, vaccination cost and coverage rates, and vaccine efficacy. Principal model outputs included the number of health-related events and costs averted and incremental cost per disability-adjusted life year averted.


RESULTS
A national rotavirus vaccination program, regardless of number of doses per course, would prevent 4 deaths, >10,500 hospitalizations, and >64,000 outpatient visits due to rotavirus infection among children <5 years annually, resulting in ~80%, 90%, and 70% declines in these outcomes, respectively, and a ~$7 million decline in annual medical costs. A national 2- or 3-dose vaccination program would be cost-saving up to $13.30/dose ($26.60/course) or $7.98/dose ($23.94/course), respectively; very cost-effective up to $24.08 per dose ($48.16/course) or $15.18/dose ($45.54/course), respectively; and cost-effective up to $45.65/dose ($91.30/course) or $29.59/dose ($88.77/course), respectively.


CONCLUSIONS
A national rotavirus vaccination program could substantially reduce rotavirus disease burden among Taiwanese children and be potentially cost-effective, depending on the vaccine price.
Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan.
Wan-Chi
WC
Chang
Catherine
C
Yen
Cheng-Liang
CL
Chi
Fang-Tzy
FT
Wu
Yhu-Chering
YC
Huang
Jen-Shiou
JS
Lin
Fu-Chen
FC
Huang
Jacqueline E
JE
Tate
Ho-Sheng
HS
Wu
Chao A
CA
Hsiung
D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D005759:Gastroenteritis / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015233:Models, Statistical; D012400:Rotavirus Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000008:administration & dosage* / Q000191:economics*; D013624:Taiwan / Q000453:epidemiology; D014611:Vaccination / Q000191:economics* / Q000379:methods*
D022243:Rotavirus Vaccines
Cost-effectiveness; Gastroenteritis; Rotavirus; Rotavirus vaccine