Table 1.
Parameters for model input
| Parameter | Value (95% CI) | Distribution | Data source | Method | ||
|---|---|---|---|---|---|---|
| |
Total population |
Ineligible population |
Eligible population |
|
|
|
|
Birth cohort (%) |
182,662 |
168,215 (92.1%) |
14,448 (7.9%) |
- |
Statistics Netherlands [46], Dutch Perinatal Registry [38], Eurocat [37] |
Published results on birth cohort size and prevalence of high risk conditions |
|
RV incidence |
|
|
|
|
|
|
| <1 year |
18,075 (11,768; 22,932) |
Calculated |
Calculated |
Pert |
Community-based cohort study [47] |
Incidence based on simulations from original study data updated to 2011 population size, see Mangen et al. for details [45] Distribution among eligible and ineligible based on relative size of each group in birth cohort |
| 1 to 4 years |
42,218 (24,711; 56,272) |
|
|
|
|
|
| 5 to 64 years |
147,997 (41,573;282,866) |
|
|
|
|
|
| 5 to 9 years |
6.2% of 5 to 64 years |
|
|
|
|
Based on age-distribution of cases 5 to 64 years in original study data |
| 10 to 14 years |
2.9% of 5–64 years |
|
|
|
|
|
| GP visits 0 to 1 years |
21.2% (12.8; 26.5) |
Calculated |
Calculated |
Pert |
GP based cohort study [48] |
Percentage of all RV cases, based on simulations from original GP study data, see Mangen et al. for details [45]. Distribution among eligible and ineligible based on relative size of each group in birth cohort |
| GP visits 1 to 4 years |
18.7% (16.4; 19.9) |
|
|
|
|
|
| GP visits 5 to 14 years |
4.0% (1.8; 4.7) |
|
|
|
|
|
| Hospitalization (95% CI) |
Calculated |
3,884 (3,244; 4,524) |
491 (357; 626) |
Pert |
RoHo-study |
Weighted incidence estimation based on original study data, see Bruijning-Verhagen et al. for details [33]. |
| Nosocomial (95% CI) |
Calculated |
227 (162; 293) |
269 (172; 365) |
Pert |
RoHo-study |
Weighted incidence estimation based on original study data, see Bruijning-Verhagen et al. for details [33] |
| Mortality rate (per 1,000 RV hospitalizations) |
Calculated |
0.00 (0.00; 0.04) |
0 81 (0.36; 1.46) |
Triangular |
RoHo study, External dataset Sophia Children’s hospital |
Observed mortality cases from both sources were combined for weighted mortality rate estimation |
| Age distribution of RV hospitalizations and fatal cases |
Additional file 1: Table S2 |
|
RoHo study |
|
||
|
Utilities RV gastroenteritis |
QALY Loss |
|
|
|
||
| Mild (RV episode without medical care) |
0.0011/0.002a |
|
GP study in Canada [49], Previous CEA [9] |
Published data |
||
| Moderate (GP visit) |
0.0022/0.004a |
|
|
|
||
| Severe (Hospitalization) |
0.0022/0.004a |
|
|
|
||
| Nosocomial |
Calculated |
Calculated |
Calculated |
|
RoHo Study |
Based on severity distribution of nosocomial cases observed in RoHo-study |
| Mortality |
Calculated |
80.7 minus patient’s age |
Simulated, whereby assuming a life expectancy of 1; 20; 41.3 minus patient’s age with probability of 1/3 eachb |
Uniform |
Statistics Netherlands [46], Expert opinion |
For ineligible: Based on average life expectancy in the Netherlands. For eligible: Based on expert panel† |
|
Direct healthcare costs (Euro) |
|
|
|
|
|
|
| Gastroenteritis episodes without medical care |
0 |
Fixed |
|
|
||
| Standard GP visits |
29 |
|
Guidelines for health-economic evaluations [39] |
Standard Cost Prices. See Mangen et al. for details [45] |
||
| Home visit GP |
45 |
|
|
|
||
| GP consultation by phone |
15 |
|
|
|
||
| Prescriptions |
40 |
|
Community-based cohort study and GP based cohort study [49,50] |
See Mangen et al. [45] |
||
| Laboratory costs |
73 |
|
|
|
||
| Hospitalization |
Calculated |
2,179 (2,027;2,330) |
2,550 (2,508; 3,606) |
Pert |
RoHo study |
Weighted estimates from original study data, see Additional file 1 |
| Nosocomial |
Calculated |
1,995 (1,242; 2,748) |
2,129 (1,203; 3,055) |
|
|
|
|
Direct non-healthcare costs |
|
|
|
|
|
|
| RV episode without medical care |
Additional diapers |
Uniform |
Assumption |
See Mangen et al. [45] |
||
| GP visits |
Additional diapers and travel costs |
|
Guidelines for health-economic evaluations [39] |
|
||
| Hospitalization |
Travel costs |
Pert |
|
|
||
| Nosocomial |
|
|
|
|
|
|
|
Indirect non-healthcare costsc |
|
|
|
|
||
| Costs per hour work loss (euro) |
31.11 |
Fixed |
Statistics Netherlands [48] Guidelines for health-economic evaluations [39] |
See Mangen et al. [45] |
||
| Hours of work loss for RV episode without medical care |
0.93; 1.36; 0.84 for ages 0 to 4; 5 to 9 and 10 to 14 years respectively |
Uniform |
Community-based cohort study and GP based cohort study [49,50] |
Dependent of patient-age. See Mangen et al. [45] |
||
| Hours of work loss GP visits |
1.35; 1.98; 1.23 for ages 0 to 4; 5 to 9 and 10 to 14 years respectively |
Uniform |
|
|
||
| Hours of work loss Hospitalization |
37.32 |
|
hospital based observational study [51] |
Based on the findings from Friesema et al. [52] for children up to 18, Further details see Mangen et al. [45] |
||
| Hours of work loss Nosocomial |
24.58 |
|
|
Based on the findings from Friesema et al. [52] for children up to 18, adjusted for excess duration of hospitalization among nosocomial in RoHo study (2.7 versus 2.9 days) |
||
|
Vaccine efficacy |
Table 2 |
|
Vaccine trials [53-57] |
|
||
|
Herd-immunity |
Universal RV vaccination |
Targeted RV vaccination |
|
|
|
|
| |
30% (0% to 46%) |
- |
|
Triangular |
Observational studies from US [58,59], Australia [60,61], Belgium [62] |
Published data |
|
Vaccination costs |
|
|
|
|
|
|
| RV1 |
60; 75; 90 |
80; 100; 120 |
|
Previous CEA [10] For Eligible: Assumption |
Assumed tender Price |
|
| RV5 |
60; 75; 90 |
80; 100; 120 |
|
|
|
|
| Startup costs first year |
218,440 |
- |
|
|
|
|
| Application costs |
6.44 |
|
|
See Mangen et al. [45] |
||
| Administration costs | 1.64 | |||||
aincludes QALY’s lost by caretakers; ball observed fatal RV cases occurred among patients with severe congenital conditions associated with limited life-expectancy (LE). To generate valid estimates of life years lost (YLL) due to RV for each fatal case, four pediatricians (PB, MF, MvH, NH) were individually asked to provide estimates of LE without RV infection based on the patient’s medical records. Pediatricians were requested to estimate for each individual fatal RV case the probability that LE without RV would have been ≤1 year, 1 to 20, 20 to 40 years or comparable to healthy infants. Independent estimates for all seven observed cases were pooled to generate a distribution of mean YLL per fatal RV case; ccosts of third person taking care of sick child.
GP: general practitioner; QALY: quality-adjusted life years; RV: rotavirus.