title: The cost effectiveness of rotavirus vaccination in Iran.
abstract: Rotavirus is the most common cause of severe diarrhea leading to hospitalization or disease-specific death among young children. Effective vaccines have recently been approved and successful vaccination program implemented. The aim of this study was to evaluate the cost effectiveness of mass rotavirus vaccination program in Iran. We developed a Markov model that reflects key features of rotavirus natural history. Parameters of the model were assessed by field study or developed through literature search and published data. We applied the model to the 2009 Iranian birth cohort and evaluated the cost-effectiveness of including the rotavirus vaccine (Rotarix®) into Iranian expanded immunization program (EPI). With an estimated hospitalization rate of 0.05 and outpatient rate of 0.23 cases per person-year, vaccinating cohort of 1231735 infants in Iran with 2 doses of (Rotarix®), would prevent 32092 hospitalizations, 158750 outpatient visits, and 1591 deaths during 5 y of follow-up. Under base-case assumption of $10 cost per course of vaccine, the vaccination would incur an extra cost of $1,019,192 from health care perspective and would avert 54680 DALYs. From societal perspective, there would be $15,192,568 saving for the society with the same averted DALYs. The incremental cost effectiveness ratio showed a cost of $19 US dollars per averted DALY from health care perspective and a saving of $278 US dollars for each averted DALY from societal perspective. Introducing rotavirus vaccine into EPI program would be highly cost-effective public health intervention in Iran.
authors.affiliation: a Aging Research Center, Sabzevar University of Medical Sciences , Sabzevar , Iran.
authors.forename: Yasaman
authors.initials: Y
authors.lastname: Mousavi Jarrahi
authors.affiliation: b Center for Communicable Disease Control, Ministry of Health and Medical Education , Tehran , Iran.
authors.forename: Seyed Mohsen
authors.initials: SM
authors.lastname: Zahraei
authors.affiliation: c Kermanshah University of Medical Sciences , Kemanshah , Iran.
authors.forename: Nader
authors.initials: N
authors.lastname: Sadigh
authors.affiliation: d Medical School, Shahid Beheshti Univesrsity of Medical Sciences and Health Services , Tehran , Iran.
authors.forename: Keyhan
authors.initials: K
authors.lastname: Esmaeelpoor Langeroudy
authors.affiliation: e Department of Epidemiology , Faculty of Health , Iran University of Medical Sciences , Tehran, Iran.|f Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences , Tehran , Iran.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Khodadost
authors.affiliation: g Department of Epidemiology , Faculty of Health, Arak University of Medical Sciences , Arak , Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Ranjbaran
authors.affiliation: d Medical School, Shahid Beheshti Univesrsity of Medical Sciences and Health Services , Tehran , Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Sanjari Moghaddam
authors.affiliation: d Medical School, Shahid Beheshti Univesrsity of Medical Sciences and Health Services , Tehran , Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Besharat
authors.affiliation: d Medical School, Shahid Beheshti Univesrsity of Medical Sciences and Health Services , Tehran , Iran.|h Faculty of Health Sciences, Simon Fraser University , BC , Canada.
authors.forename: Alireza
authors.initials: A
authors.lastname: Mosavi Jarrahi
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007492:Iran / Q000453:epidemiology; D012400:Rotavirus Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000008:administration & dosage* / Q000191:economics*; D014611:Vaccination / Q000191:economics*
chemical_list: D022243:Rotavirus Vaccines
keywords: Cost-effectiveness; Iran; rotavirus; rotavirus incidence; vaccination