Table 4.
Discounted Cost-Effectiveness of Rotavirus Vaccine (20 Cohorts Vaccinated During the Period 2014–2033)
| Scenario | Government Perspective | Societal Perspective |
|---|---|---|
| Cost-effectiveness threshold | ||
| 1 × GDP per capita (2014)–WHO threshold for “highly cost-effective” [4] | $253 | $253 |
| 3 × GDP per capita (2014)–WHO threshold for “cost-effective” [4] | $759 | $759 |
| Cost-effectiveness compared to no vaccine | ||
| Net cost of vaccine and related program costs | $2 529 646 | $1 308 333 |
| Costs of vaccine program | $10 528 367 | $10 528 367 |
| Health service costs avoided | $7 998 721 | $9 220 034 |
| DALYs averted | 136 290 | 136 290 |
| US$ per DALY averted | $19 | $10 |
| Univariate sensitivity analyses (in US$ per DALY averted) | ||
| Gavi withdraws support in 2023 | $161 | $152 |
| Gavi withdraws support in 2028 | $88 | $79 |
| Increased systems cost of 25% to $0.53 per dose | $32 | $23 |
| No waning immunity in second year of life | $2 | Cost-savinga |
| Genotype changes lowering VE 15 percentage points | $160 | $150 |
| Lower cost of rotavirus care (lower bound of 95% CI in Table 2) | $24 | $18 |
| Case fatality rate 2%.5% | $32 | $16 |
Costs and DALYs are discounted at 3% per year.
Abbreviations: CI, confidence interval; DALY, disability-adjusted life-year; GDP, gross domestic product; VE, vaccine effectiveness; WHO, World Health Organization.
a This scenario is cost saving to a total of $1.29 million.