Cost effectiveness analysis of rotavirus vaccination in Indonesia

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2024-11-04 DOI:10.1016/j.vaccine.2024.126478

Jarir At Thobari , Emma Watts , Natalie Carvalho , Jonathan Hasian Haposan , Andrew Clark , Frédéric Debellut , Asal Wahyuni Erlin Mulyadi , Julitasari Sundoro , Mardiati Nadjib , Sri Redzeki Hadinegoro , Julie Bines , Yati Soenarto

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引用次数: 0

Abstract

Background

Rotavirus (RV) remains the most common cause of morbidity and mortality due to acute gastroenteritis (AGE) in children under five. In Indonesia, RV is responsible for 60 % of severe AGE and 40 % of non-severe AGE in these children. This study assessed the cost-effectiveness of introduction of rotavirus vaccines (RVV) into the National Immunization Program in Indonesia.

Methods

We conducted a cost-effectiveness analysis (CEA) of RVV introduction in Indonesia, assuming a three-dose vaccine schedule based on the planned introduction proposed by the Strategic Advisory Group of Experts on Immunization. The analysis involved an initial introduction of an imported RVV (Rotavac®, Bharat Biotech, India) followed by a staged implementation of the locally produced RVV (Bio Farma, Indonesia) from both health system and societal perspectives. The primary outcome measure was the incremental cost (2019 USD) per disability-adjusted life year (DALY) averted, compared to no vaccination. We took model inputs from an Indonesian cost-of-illness study, national information systems and scientific literature, covering disease incidence, hospitalization, mortality, healthcare costs, and vaccine related factors. Our analyses included univariate and probabilitistic sensitivity analyses to assess various parameters.

Findings

The cost of a 10-year vaccination program is 82.6 million USD and can potentially prevent 7.3 million cases of rotavirus and 0.42 million DALYs. From a societal perspective, the incremental cost-effectiveness ratio (ICER) for the staged program is 464 USD per DALY averted (12 % of Indonesia's gross domestic product (GDP) per capita). From a healthcare sector perspective, ICER is similar at 479 USD (13 % GDP per capita).

Interpretation

The introduction of RVV into the National Immunization Program is likely to be highly cost-effective in Indonesia.

Funding

This work was supported by funding agreement with the Murdoch Children's Research Institute (MCRI), PATH, and the Indonesian Technical Advisory Group on Immunization (ITAGI).

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印度尼西亚轮状病毒疫苗接种的成本效益分析

背景轮状病毒（RV）仍然是导致五岁以下儿童急性肠胃炎（AGE）发病和死亡的最常见原因。在印度尼西亚，60%的严重急性肠胃炎和 40%的非严重急性肠胃炎是由轮状病毒引起的。本研究评估了在印尼国家免疫计划中引入轮状病毒疫苗（RVV）的成本效益。方法我们对在印尼引入轮状病毒疫苗进行了成本效益分析（CEA），假定根据免疫战略专家顾问小组提出的计划引入三剂疫苗。分析从卫生系统和社会角度出发，首先引入进口 RVV（Rotavac®，印度巴拉特生物技术公司），然后分阶段引入本地生产的 RVV（Bio Farma，印度尼西亚）。主要结果指标是与不接种疫苗相比，每避免一个残疾调整生命年 (DALY) 的增量成本（2019 年美元）。我们从印尼疾病成本研究、国家信息系统和科学文献中获取模型输入，涵盖疾病发病率、住院率、死亡率、医疗成本和疫苗相关因素。我们的分析包括单变量和概率敏感性分析，以评估各种参数。研究结果为期 10 年的疫苗接种计划的成本为 8260 万美元，可潜在预防 730 万例轮状病毒病和 42 万个残疾调整寿命年。从社会角度来看，分阶段计划的增量成本效益比 (ICER) 为每避免 1 DALY 464 美元（占印度尼西亚人均国内生产总值 (GDP) 的 12%）。从医疗保健部门的角度来看，ICER 与之相近，为 479 美元（人均国内生产总值的 13%）。解释在印度尼西亚的国家免疫计划中引入 RVV 可能具有很高的成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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