The Cost-Effectiveness of Rotavirus Vaccination in Malawi

Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
The Journal of Infectious Diseases (Impact Factor: 5.78). 09/2010; 202 Suppl:S108-15. DOI: 10.1086/653578
Source: PubMed

ABSTRACT Rotarix (GlaxoSmithKline), a newly licensed rotavirus vaccine requiring 2 doses, may have the potential to save hundreds of thousands of lives in Africa. Nations such as Malawi, where Rotarix is currently under phase III investigation, may nevertheless face difficult economic choices in considering vaccine adoption.
The cost-effectiveness of implementing a Rotarix vaccine program in Malawi was estimated using published estimates of rotavirus burden, vaccine efficacy, and health care utilization and costs.
With 49.5% vaccine efficacy, a Rotarix program could avert 2582 deaths annually. With GAVI Alliance cofinancing, adoption of Rotarix would be associated with a cost of $5.07 per disability-adjusted life-year averted. With market pricing, Rotarix would be associated with a base case cost of $74.73 per disability-adjusted life-year averted. Key variables influencing results were vaccine efficacy, under-2 rotavirus mortality, and program cost of administering each dose.
Adopting Rotarix would likely be highly cost-effective for Malawi, particularly with GAVI support. This finding holds true across uncertainty ranges for key variables, including efficacy, for which data are becoming available.

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    • "The Rotarix â vaccine was implemented in Malawi's national immunisation programme in October 2012 (GAVI Alliance 2012c). It has been estimated that the implementation could prevent 2582 deaths annually (Berry et al. 2010). Malawi has been approved for 3 years of financial support through the GAVI Alliance, and thus, the country only needs to co-finance a small fraction of the vaccine cost (GAVI Alliance 2012a). "
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