Table 1.
Parameters for model input
| Parameter | Total population | Non-target group | Target group | Distribution | Data source | Method |
|---|---|---|---|---|---|---|
| Birth cohort n (%) | 171,387 | 157,847 (92.1%) | 13,540 (7.9%) | Fixed | Statistics Netherlands [46, 47] | Birth cohort size 2016. Prevalence of high-risk conditions, same as in Bruijning et al. [11] |
| Rotavirus incidence | Most likely value (minimum–maximum) | |||||
| Population: < 1 year | 15,188 (10,161-21,597) | Calculated | Pert | Community-based cohort study [12]; virological rotavirus surveillance data [5] | Incidence based on simulations from original study data (for details see [17]), scaled to the years 2013–2017. Distribution among non-target and target groups based on relative size of each category in birth cohort | |
| Population: 1–4 years | 35,756 (21,805-54,972) | |||||
| Population: 5–14 yearsa | 7897 (1426-26,004) | |||||
| GP visits < 1 year | 21.5% (12.8–29.1%) | Pert | GP-based cohort study [13] | Percentage of rotavirus cases based on simulations from original study data (for details see [17]) | ||
| GP visits 1–4 years | 18.5% (16.3–20.8%) | |||||
| GP visits 5–14 years | 6.4% (4.8–7.3%) | |||||
| Community-acquired (CA) hospitalization | 2024 (1789 – 2256) | 82.8% (82.7– 82.9%) of total | Calculated (total minus non-target) | Pert | RoHo study [14]; indirect estimated annual hospitalizations [2]; RIVAR AGE surveillance [18] | Incidence based on original study data (for details see [11]) and scaled to the years 2013–2016. Distribution over non-target and target groups and over CA and nosocomial cases based on active AGE surveillance in 2014–2016 |
| Nosocomial infections per CA case | Calculated | 0.21 (0.206–0.213) | 0.89 (0.88–0.90) | Pert | RIVAR AGE surveillance [18] | |
| Mortality rate/1000 hospitalizations | Calculated | 0.00 (0.00; 0.04) | 0 81 (0.36; 1.46) | Pert | RoHo study [14]; External dataset Sophia Children’s hospital | For details see [11] |
| Age distribution of hospitalizations and fatal cases | See Additional file 1: Table S2 in Bruijning et al. [11] | RoHo study [14]; | Same as [11] | |||
| Intussusception (IS) incidence | ||||||
| Vaccine-induced IS risk | 1/50,000 vaccinated children | Fixed | [32–35] | |||
| Complicated (with intestinal resection) | 4.8% of induced IS cases | Fixed | [36] | Calculated from [36]: 56 with resection out of 1176 IS cases in infants < 12 months | ||
| Utilities rotavirus AGE | QALY loss | |||||
| Mild (no medical care) | 0.0011 | Fixed | GP study in Canada [48] | 50% of estimate for moderate, similar to [11, 17, 31, 49] | ||
| Moderate (GP visit only) | 0.0022 | Fixed | GP study in Canada [48] | |||
| Severe (hospitalization) | 0.0034 | Fixed | Emergency-department study in UK [20] | |||
| Nosocomial | Calculated | Calculated | Calculated | RoHo study [14] | Based on severity distribution, same as in [10] | |
| Rotavirus fatal cases | Calculated | 81.5 minus patient age at rotavirus infection | Simulated, assuming LE of 1; 20; 41.3 minus patient’s age with probability of 1/3 each | Uniform | Statistics Netherlands [46]; Expert panel [11] | For non-target group, based on average LE in the Netherlands. For target group, same as Bruijning et al. [11] |
| Utilities intussception | QALY loss | |||||
| Uncomplicated IS | 0.0037 | Fixed | Based on Reyes et al. [37] | |||
| Complicated IS | 0.0111 | Fixed | Assumption | Assuming three times more severe than uncomplicated IS; see Additional file 1 | ||
| Healthcare costs [?A3B2 show $9#?]rotavirus AGE | ||||||
| No medical care | €0 | Fixed | ||||
| Standard GP visit (€/unit) | €33 | Dutch reference prices [22] | If GP attendance; home visit: Pert (0; 0.1; 0.1), standard GP visit: Pert (0.9; 0.9; 1.0), and GP telephone consultation: Pert (0; 0.97; 0.97); same as in [11, 17] Average cost/episode including antibiotics, oral rehydration solutions, and other prescribed drugs/GP consultation (home or standard GP visit) Additional GP consultations for hospitalized cases same as in [11], based on [50] |
|||
| GP home visit (€/unit) | €50 | |||||
| GP telephone consultation (€/unit) | €17 | Based on cohort studies [12, 13, 51] | ||||
| Drug costs incl. Prescription fee (€/unit) | €43 | |||||
| Laboratory costs (€/unit) | €78 | Expert elicitation | 10% with laboratory test [52] | |||
| Ambulance (€/unit) | €618.6 | Fixed | Dutch reference price [22]; hospital-based observational study [50] | 1% of hospitalized cases transported by ambulance [50] | ||
| Rotavirus hospitalization (€/hospitalization) | Calculated | €2417 (2248–2584) | €2828 (2782–4000) | Pert | RoHo study [11] | Weighted estimates from original study data (see additional file in [11]) |
| Nosocomial rotavirus (€/hospitalization) | Calculated | €2413 (1378–3048) | €2361 (1334–3388) | |||
| Uncomplicated IS (€/hospitalization) | €1423 | Fixed | Hospital administrative data (see Additional file 1); Valk et al. [53] | Average LOS for Dutch IS cases = 2.11 days + costs of diagnostics (i.e., abdominal X-ray, ultrasonography) | ||
| Complicated IS (€/hospitalization) | €6759 | Fixed | Assumption | 3× LOS for uncomplicated IS, whereof 1 day in ICU, and additional procedures (i.e., ileocecal resection, abdominal X-ray, ultrasonography). See Additional file 1 | ||
| Patient and family costs for rotavirus AGEb | ||||||
| Without medical care | Additional diapers | Uniform | Assumption | For details see [11, 17] | ||
| Requiring GP visit | Additional diapers and travel costs | Pert | Assumptions and guidelines for health economic evaluation [22] | |||
| Hospitalization | Travel costs | |||||
| Nosocomial rotavirus | Not applicable | |||||
| Productivity losses caregiver | ||||||
| Cost per hour paid work loss | €32 | Statistics Netherlands [54] and guidelines for health economic evaluation [22] | ||||
| Hours of paid work loss per episode: | ||||||
| Without medical care | 1 day (~ 8 h) in 5% of episodes | Beta | RotaFam (see Additional file 1) | For children > 10 years of age work loss estimates were reduced by 50% | ||
| Requiring GP visit | 0.5–2 days in 25% of episodes | Beta; uniform | RotaFam (see Additional file 1) | |||
| Hospitalization | 26.40 | Based on [50] | For details see [17] | |||
| Nosocomial AGE | 24.58 | Based on [50] | For details see [11] | |||
| Uncomplicated IS | 4.93 | Fixed | Estimated based on LMR data (see Additional file 1) and Statistics Netherlands [54] | Based on LOS and applying average caregiver employment of 16.4 h/week (similar to Mangen et al. [38])d | ||
| Complicated IS | 14.79 | Fixed | ||||
| Vaccine coverage | Universal vaccination | Targeted vaccination | ||||
| Vaccine coverage | 86.2% | 86.2% | Fixed | Discrete choice experiment [28] | ||
| Vaccine efficacy | Table 2 in Bruijning et al. [11] | Pert | Vaccine trials [55–57] | |||
| Herd protection | See Table 2 | Not applicable | Fixed | Published estimates, see Table 2 | Only for universal vaccination scenarios | |
| Vaccination costs | ||||||
| Vaccine costs/infantsc | €75 | €135.32 | Fixed | Free market price for targeted vaccination [29]; for universal vaccination based on assumption as in [11, 31] | ||
| Application and administration costs | €12.36 | €12.36 | Fixed | [30] | ||
| Start-up cost first year | €233,760 | Fixed | [17] | |||
LOS length of hospital stay, LE life expectancy, RIVAR Risk-Group Infant Vaccination Against Rotavirus, LMR Netherlands National Medical Registry
aOf which 80% is aged 5–9 years and 20% is aged 10–14 years
bNote, we did not consider any patient and family costs for IS cases
cReported vaccine costs exclude costs for spillage; 2% spillage costs was added in the model
dBased on population statistics for the year 2014 [54], the most recent year available, we calculated similarly as in Mangen et al. [38] the average working hours/week for a primary caregiver. For this we assumed that, except for single-father households, the female is the primary caregiver taking care of a sick child. In 2014 73.4% of primary caregivers had paid employment, for an average of 22.3 h/week. For an average primary caregiver in the Netherlands this corresponds to 16.4 h/week