Table 3.
Cost-effectiveness analysis results, payer’s perspective.
| Comparators used for the analysis |
|||||
|---|---|---|---|---|---|
| HRV_1d | HBRV_1d | BRV-PV_2d | BRV-PV_1d | ||
| Doses per FIC | No_vacc | 2 | 3 | 3 | 3 |
| Natural disease module | |||||
| RV cases | |||||
| RVGE homecare | 1,561,026 | 739,593 | 763,615 | 763,615 | 763,615 |
| RVGE medical visits | 603,532 | 234,968 | 245,747 | 245,747 | 245,747 |
| RVGE hospitalization | 18,660 | 5,263 | 5,655 | 5,655 | 5,655 |
| RVGE deaths | 486 | 76 | 88 | 88 | 88 |
| Costs | |||||
| Direct medical disease management costs | $ 36,633,165 | $ 13,181,344 | $ 13,867,193 | $ 13,867,193 | $ 13,867,193 |
| Costs of RVGE homecare treatment | $ 1,561 | $ 740 | $ 764 | $ 764 | $ 764 |
| Costs of RVGE medical visits | $ 26,555,409 | $ 10,338,596 | $ 10,812,857 | $ 10,812,857 | $ 10,812,857 |
| Costs of RVGE hospitalization | $ 10,076,195 | $ 2,842,009 | $ 3,053,572 | $ 3,053,572 | $ 3,053,572 |
| Direct non-medical costs | $ 0 | $ 0 | $ 0 | $ 0 | $ 0 |
| Transportation costs | $ 0 | $ 0 | $ 0 | $ 0 | $ 0 |
| Other costs | $ 0 | $ 0 | $ 0 | $ 0 | $ 0 |
| Productivity losses of informal caregivers for RV disease management | $ 0 | $ 0 | $ 0 | $ 0 | $ 0 |
| Health outcomes | |||||
| QALY losses due to | |||||
| RVGE homecare | 433 | 205 | 212 | 212 | 212 |
| RVGE medical visits | 725 | 282 | 295 | 295 | 295 |
| RVGE hospitalization | 101 | 28 | 31 | 31 | 31 |
| Premature mortality due to RVGE events – undiscounted | 31,981 | 4,968 | 5,758 | 5,758 | 5,758 |
| Premature mortality due to RVGE events – discounted | 9,795 | 1,522 | 1,764 | 1,764 | 1,764 |
| Intervention Control System | |||||
| Vaccination doses delivered | |||||
| Total doses administered | 3,574,347 | 5,361,520 | 5,361,520 | 5,361,520 | |
| Total doses required (incl. wastage) | 3,723,278 | 5,584,917 | 8,510,350 | 5,584,917 | |
| Total volume of all purchased doses (cm3) | 63,668,054 | 258,302,413 | 179,483,276 | 196,309,834 | |
| Total vaccination costs | |||||
| Vaccination cost | $ 24,303,635 | $ 26,679,232 | $ 10,265,759 | $ 18,939,838 | |
| Vaccine costs, incl. wastage | $ 23,270,488 | $ 24,936,655 | $ 8,084,832 | $ 16,754,751 | |
| Vaccine administration costs | $ 1,017,409 | $ 1,678,725 | $ 2,136,559 | $ 2,136,559 | |
| Fixed overhead costs for all vaccines | $ 0 | $ 0 | $ 0 | $ 0 | |
| Waste disposal | $ 15,739 | $ 63,852 | $ 44,368 | $ 48,528 | |
| Supply chain costs | $ 673,148 | $ 1,015,013 | $ 476,997 | $ 717,141 | |
| International transport | $ 465,410 | $ 498,733 | $ 161,697 | $ 335,095 | |
| International handling | $ 109,371 | $ 117,202 | $ 37,999 | $ 78,747 | |
| Storage costs | $ 27,314 | $ 110,812 | $ 76,998 | $ 84,217 | |
| Transport costs | $ 71,054 | $ 288,265 | $ 200,303 | $ 219,082 | |
| Local coordination costs | $ 0 | $ 0 | $ 0 | $ 0 | |
| Coordination & invitation costs | $ 0 | $ 0 | $ 0 | $ 0 | |
| Attending costs | $ 0 | $ 0 | $ 0 | $ 0 | |
| Total Costs | $ 36,633,165 | $ 38,158,128 | $ 41,561,437 | $ 24,609,949 | $ 33,524,172 |
| Natural disease module | $ 36,633,165 | $ 13,181,344 | $ 13,867,193 | $ 13,867,193 | $ 13,867,193 |
| Intervention control system | $ 0 | $ 24,976,784 | $ 27,694,244 | $ 10,742,756 | $ 19,656,979 |
| Total QALY losses undiscounted | 33,240 | 5,484 | 6,296 | 6,296 | 6,296 |
| Natural disease module | 33,240 | 5,484 | 6,296 | 6,296 | 6,296 |
| Intervention control system | 0 | 0 | 0 | 0 | 0 |
| Total QALY losses discounted | 11,054 | 2,038 | 2,301 | 2,301 | 2,301 |
| Natural disease module | 11,054 | 2,038 | 2,301 | 2,301 | 2,301 |
| Intervention control system | 0 | 0 | 0 | 0 | 0 |
| Incremental cost-effectiveness ratio vs HRV (USD cost/QALY gained) | -$12,907 (dominated) | $51,380 | $17,574 | ||
BRV-PV, bovine rotavirus pentavalent vaccine; FIC, fully immunized child; HBRV, human-bovine reassortant rotavirus vaccine; HRV, human rotavirus vaccine; incl., including; RV, rotavirus; RVGE, rotavirus gastroenteritis; QALY, quality-adjusted life-year; USD, US dollar.
No_vacc, refers to no vaccination; HRV_1d refers to HRV in a 1-dose per vial presentation; HBRV_1d refers to HBRV in a 1-dose per vial presentation; BRV-PV_2d refers to BRV-PV in a 2-dose per vial presentation; BRV-PV_1d refers to BRV-PV in a 1-dose per vial presentation.