Economic evaluation of rotavirus vaccination: an important step of the introduction to the national immunization program in Thailand

ABSTRACT

Introduction

World Health Organization recommends rotavirus vaccine for all national immunization programs (NIPs). To provide country-specific evidence, we conducted economic evaluation of a monovalent rotavirus vaccination using specific data of the pilot phase in Thailand.

Method

A Markov model was adopted to compare the 2020 birth cohort once receiving rotavirus vaccination versus no vaccination from healthcare and societal perspective over five years. Data on disease burden, vaccine effectiveness, costs, and utilities were taken from a cohort study in two provinces of Thailand.  Sensitivity analyses were performed to test the robustness of the results.

Results

Rotavirus vaccination would reduce rotavirus diarrhea and costs of illness by 48% and 71%, respectively, over the first five years of life. At USD 13 per dose, vaccine was cost-effective with the ICERs of USD 4,114 and USD 1,571per QALY gained from healthcare and societal perspective, respectively. Results were sensitive to incidence and vaccine cost.  The budget for vaccine purchasing was estimated at USD13 million per year.

Conclusion

Incorporating rotavirus vaccination into the NIP substantially reduced health and cost outcomes and was cost-effective for both perspectives. However, the government needs to negotiate vaccine price prior to program implementation to achieve favorable budget impact.

KEYWORDS:

• Economic
• rotavirus
• vaccination
• national immunization program
• Thailand

Acknowledgments

Open Access funding provided by the Qatar National Library.

This publication is a part of study in Doctor of Philosophy (Pharmacy Administration), Faculty of Pharmacy, Mahidol University, Bangkok, Thailand. We would like to thank the staffs in Sukhothai and Phetchabun provinces for helping with data collection and the Department of Disease Control for supporting and facilitating the study.

Author contributions

OR, AR, PT, and SJ conceptualized and designed the study. OR, PT, and SJ collected data. OR, NP, and AR analyzed the data and drafted the manuscript. MT and MJP contributed to the study design, supervision, and the discussion. All authors revised and approved the final manuscript before submission.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Data availability statement

In terms of all tables and figures we submitted, we confirm that all tables and figures are original. They have not been published elsewhere.

Additional information

Funding

This work was supported by the Thailand Research Fund through the Royal Golden Jubilee Ph.D. Program (Grant No. PHD/0186/2552) and the Department of Disease Control. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.