Economic Evaluation of Rotavirus Vaccination in Children Aged Under Five Years in South Africa.

IF 2.9 3区医学 Q2 PHARMACOLOGY & PHARMACY

Clinical Drug Investigation Pub Date : 2023-11-01 Epub Date: 2023-10-13 DOI:10.1007/s40261-023-01312-4

Ahmed Mohy, Nicola Page, Welekazi Boyce, Jorge A Gomez

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Abstract

Background and objective: Evidence on the economic value of rotavirus vaccines in middle-income countries is limited. We aimed to model the implementation of three vaccines (human rotavirus, live, attenuated, oral vaccine [HRV, 2 doses]; rotavirus vaccine, live, oral, pentavalent [HBRV, 3 doses] and rotavirus vaccine, live attenuated oral, freeze-dried [BRV-PV, 3 doses] presented in 1-dose and 2-dose vials) into the South African National Immunisation Programme.

Methods: Cost and cost-effectiveness analyses were conducted to compare three rotavirus vaccines using a static, deterministic, population model in children aged <5 years in South Africa from country payer and societal perspectives. Deterministic and probabilistic sensitivity analyses were conducted to assess the impact of uncertainty in model inputs.

Results: The human rotavirus, live, attenuated, oral vaccine (HRV) was associated with cost savings versus HBRV from both perspectives, and versus BRV-PV 1-dose vial from the societal perspective. In the cost-effectiveness analysis, HRV was estimated to avoid 1,107 home care rotavirus gastroenteritis (RVGE) events, 247 medical visits, 35 hospitalisations, and 4 RVGE-related deaths versus HBRV and BRV-PV. This translated to 73 quality-adjusted life years gained. HRV was associated with lower costs versus HBRV from both payer (-$3.9M) and societal (-$11.5M) perspectives and versus BRV-PV 1-dose vial from the societal perspective (-$3.8M), dominating those options. HRV was associated with higher costs versus BRV-PV 1-dose vial from the payer perspective and versus BRV-PV 2‑dose vial from both payer and societal perspectives (ICERs: $51,834, $121,171, and $16,717, respectively), exceeding the assumed cost-effectiveness threshold of 0.5 GDP per capita.

Conclusion: Vaccination with a 2-dose schedule of HRV may lead to better health outcomes for children in South Africa compared with the 3-dose schedule rotavirus vaccines.

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南非五岁以下儿童接种轮状病毒疫苗的经济评估。

背景和目的：关于轮状病毒疫苗在中等收入国家的经济价值的证据有限。我们旨在对南非国家免疫计划中三种疫苗（人轮状病毒活疫苗、减毒口服疫苗[HRV，2剂]；轮状病毒疫苗、活疫苗、口服五价疫苗[HBRRV，3剂]和轮状病毒减毒口服活疫苗、冻干疫苗[BRV-PV，3剂）的实施进行建模。方法：成本和成本效益分析使用静态、确定性的儿童群体模型对三种轮状病毒疫苗进行了比较。结果：从两个角度来看，人类轮状病毒减毒活口服疫苗（HRV）与HBRV相比，以及从社会角度来看，与BRV-PV单剂量小瓶相比，都与成本节约有关。在成本效益分析中，与HBRV和BRV-PV相比，HRV估计可避免1107例家庭护理轮状病毒肠胃炎（RVGE）事件、247次就诊、35次住院和4例RVGE相关死亡。这意味着增加了73年的质量调整寿命。从付款人（-390万美元）和社会（-1150万美元）的角度来看，HRV与较低的HBRV成本相关，从社会角度来看，与BRV-PV 1剂量小瓶（-38万美元）相比，HRV占主导地位。从付款人的角度来看，HRV与BRV-PV 1剂量小瓶和从付款人和社会的角度来看BRV-PV 2剂量小瓶相比，成本更高（ICERs：分别为51834美元、121171美元和16717美元），超过了人均GDP 0.5的假设成本效益阈值。结论：与3剂轮状病毒疫苗相比，接种2剂计划的HRV疫苗可能会为南非儿童带来更好的健康结果。

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

Clinical Drug Investigation 医学-药学

CiteScore

5.90

自引率

3.10%

发文量

108

审稿时长

6-12 weeks

期刊介绍： Clinical Drug Investigation provides rapid publication of original research covering all phases of clinical drug development and therapeutic use of drugs. The Journal includes: -Clinical trials, outcomes research, clinical pharmacoeconomic studies and pharmacoepidemiology studies with a strong link to optimum prescribing practice for a drug or group of drugs. -Clinical pharmacodynamic and clinical pharmacokinetic studies with a strong link to clinical practice. -Pharmacodynamic and pharmacokinetic studies in healthy volunteers in which significant implications for clinical prescribing are discussed. -Studies focusing on the application of drug delivery technology in healthcare. -Short communications and case study reports that meet the above criteria will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in Clinical Drug Investigation may be accompanied by plain language summaries to assist readers who have some knowledge, but non in-depth expertise in, the area to understand important medical advances.