title: Cost-Effectiveness of Rotavirus Vaccination for Under-Five Children in Iran.
abstract: BACKGROUND
  Rotavirus diarrhea is one of the most important causes of death among under-five children. Anti-rotavirus vaccination of these children may have a reducing effect on the disease.
  
  
  OBJECTIVE
  this study is intended to contribute to health policy-makers of the country about the optimal decision and policy development in this area, by performing cost-effectiveness and cost-utility analysis on anti-rotavirus vaccination for under-5 children.
  
  
  METHODS
  A cost-effectiveness analysis was performed using a decision tree model to analyze rotavirus vaccination, which was compared with no vaccination with Iran's ministry of health perspective in a 5-year time horizon. Epidemiological data were collected from published and unpublished sources. Four different assumptions were considered to the extent of the disease episode. To analyze costs, the costs of implementing the vaccination program were calculated with 98% coverage and the cost of USD 7 per dose. Medical and social costs of the disease were evaluated by sampling patients with rotavirus diarrhea, and sensitivity analysis was also performed for different episode rates and vaccine price per dose.
  
  
  RESULTS
  For the most optimistic assumption for the episode of illness (10.2 per year), the cost per DALY averted is 12,760 and 7,404 for RotaTeq and Rotarix vaccines, respectively, while assuming the episode of illness is 300%, they will be equal to 2,395 and 354, respectively, which will be highly cost-effective. Number of life-years gained is equal to 3,533 years.
  
  
  CONCLUSIONS
  Assuming that the illness episodes are 100% and 300% for Rotarix and 300% for Rota Teq, the ratio of cost per DALY averted is highly cost-effective, based on the threshold of the world health organization (< 1 GDP per capita = 4526 USD). The implementation of a national rotavirus vaccination program is suggested.
authors.affiliation: School of Medical Education, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, IR Iran.
authors.forename: Sareh
authors.initials: S
authors.lastname: Shakerian
authors.affiliation: Department of Community Medicine, Gastro-Intestinal and Liver Disease Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Maziar
authors.initials: M
authors.lastname: Moradi Lakeh
authors.affiliation: Department of Pediatrics, Akbarabadi Hospital, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Abdoulreza
authors.initials: A
authors.lastname: Esteghamati
authors.affiliation: Ministry of Health and Medical Education, Tehran, IR Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Zahraei
authors.affiliation: Clinical Knowledge Management Unit, Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Yaghoubi
keywords: Rotavirus, Acute Diarrhea, Cost-Effectiveness, Iran, Children