Evaluation of the Cost-Effectiveness of Vaccination of Children with 5-valent Vaccine against Rotavirus Infection in the Russian Federation

Abstract

One of the main causes of the incidence of intestinal infections in children under 5 years infection is rotavirus. Vaccines against rotavirus infection substantially reduce morbidity.The objective of this study is to analyze cost-effectiveness of vaccination of children with 5-valent vaccine against rotavirus infection in the Russian Federation.Methods. The evaluation was carried out using modelling on the basis of published data on the effectiveness of vaccines and epidemiological data for the Russian Federation. In the base case analysis was performed from the position of the society as a whole. During the sensitivity analysis cost-effectiveness was also evaluated from the position of the health system. The evaluation was performed on the period of survival of vaccinated children. The costof therapy corresponded to the rates of OMS in St. Petersburg in 2017, the price of 1 dose of vaccine accounted for in the calculationof 1450 rubles. Costs and life expectancy with regard to quality were discounted at 3.5% per year.Results. Taking into account the accepted assumptions, the mass vaccination will prevent the vaccinated population in the average 4675 RVI outpatient cases and 1732 RVI cases requiring hospitalization per 100 thousand children the first year of life, with 90% coverage. In unvaccinated populations will be prevented 4128 outpatient cases and 1212 RVI cases requiring hospitalization. The projected amount of avoided costs in general — 2.94 thousand RUB per 1 child (54% in the vaccinated cohort, 46% in unvaccinated population). Cost-effectiveness will be in the evaluation from the perspective of society as a whole of 260.1 thousand RUB counting on an quality adjusted life year (QALY), and the evaluation from the perspective of the health system — 653.0 thousand roubles/QALY. Thus, in both cases, costeffectiveness of rotavirus vaccination per 1 QALY will not exceed the generally accepted threshold willingness-to- pay equal to three times the gross domestic product in Russia (2016 — 1.76 million RUB). The projected economic efficiency of selective vaccination 4.94 times lower than one of mass vaccination.Conclusions. Mass vaccination of children with 5-valent vaccine against RVI will not only reduce the incidence in the Russian Federation, but, given the adopted assumptions, may also be considered as a cost-effective intervention.

Keywords

• rotavirus infection
• vaccination
• cost-effectiveness