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Vaccine. 2015 May 7;33 Suppl 1:A201-8. doi: 10.1016/j.vaccine.2014.12.075.

Cost-effectiveness of rotavirus vaccination in Albania.

Author information

1
Institute of Public Health, Tirana, Albania. Electronic address: albiahmeti@yahoo.com.
2
Institute of Public Health, Tirana, Albania.
3
London School of Hygiene and Tropical Medicine (LSHTM), London, UK.
4
Pan American Health Organization (WHO/PAHO), Washington, DC, USA.
5
Agence de Médecine Préventive (AMP), Paris, France.

Abstract

BACKGROUND:

Rotavirus vaccines have been introduced in several European countries but can represent a considerable cost, particularly for countries that do not qualify for any external financial support. This study aimed to evaluate the cost-effectiveness of introducing rotavirus vaccination into Albania's national immunization program and to inform national decision-making by improving national capacity to conduct economic evaluations of new vaccines.

METHODS:

The TRIVAC model was used to assess vaccine impact and cost-effectiveness. The model estimated health and economic outcomes attributed to 10 successive vaccinated birth cohorts (2013-2022) from a government and societal perspective. Epidemiological and economic data used in the model were based on national cost studies, and surveillance data, as well as estimates from the scientific literature. Cost-effectiveness was estimated for both the monovalent (RV1) and pentavalent vaccines (RV5). A multivariate scenario analysis (SA) was performed to evaluate the uncertainty around the incremental cost-effectiveness ratios (ICERs).

RESULTS:

With 3% discounting of costs and health benefits over the period 2013-2022, rotavirus vaccination in Albania could avert 51,172 outpatient visits, 14,200 hospitalizations, 27 deaths, 950 disability-adjusted life-years (DALYs), and gain 801 life-years. When both vaccines were compared to no vaccination, the discounted cost per DALY averted was US$ 2008 for RV1 and US$ 5047 for RV5 from a government perspective. From the societal perspective the values were US$ 517 and US$ 3556, respectively.

CONCLUSION:

From both the perspectives, the introduction of rotavirus vaccine to the Albanian immunization schedule is either cost-effective or highly cost-effective for a range of plausible scenarios. In most scenarios, including the base-case scenario, the discounted cost per DALY averted was less than three times the gross domestic product (GDP) per capita. However, rotavirus vaccination was not cost-effective when rotavirus cases and deaths were based on plausible minimum estimates. Introduction of RV1 would yield similar benefits at lower cost.

KEYWORDS:

Albania; Cost-effectiveness; Diarrhea; Evidenced-based medicine; Rotavirus; Vaccine

PMID:
25919162
DOI:
10.1016/j.vaccine.2014.12.075
[Indexed for MEDLINE]

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