Master of Science Program in Social, Economic, and Administrative Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
Division of Social and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
Vaccine. 2021 Feb 22;39(8):1272-1282. doi: 10.1016/j.vaccine.2021.01.031. Epub 2021 Jan 22.
In Burundi, diarrhea is the third leading cause of mortality among children under five years of age. This study conducted an economic analysis of rotavirus vaccination program in Burundi.
A Markov model was constructed to simulate clinical and economic outcomes for the 2019 birth cohort for a period of 5 years. Empirical costing data were collected. ICER per episode averted, ICER per death averted, ICER per DALY averted, net present value, and budget impact were estimated for 4 brands of WHO pre-qualified rotavirus vaccines. One-way and probabilistic sensitivity analysis as well as threshold analysis were performed.
For the base case, while all four WHO pre-qualified rotavirus vaccines were cost-effective (ICER < 3 GDP per capita), three of them (i.e. Rotarix, Rotavac and Rotasiil) were very cost-effective (ICER <1 GDP per capita) from both the provider and societal perspectives. The vaccines were still very cost-effective at a price increase of up to US$ 5.09, US$ 3.16, US$ 3.89, and US$ 2.69 for Rotarix, RotaTeq, Rotavac, and Rotasiil, respectively. Probabilistic sensitivity analysis indicated that vaccination programs with Rotarix, RotaTeq, Rotavac, and Rotasiil are cost-effective at a probability of 93.8%, 27%, 99.1%, and 92.7%, respectively. All vaccination programs were cost-beneficial with a net present value in the range of US$ 5,214,912 and US$ 11,135,997.The budget required to run the vaccination program, estimated with break-even prices, ranged between US$ 42,249,498 and US$ 53,487,935 for a 5-year time period. When compared to the GDP of Burundi in 2019, these are are less than 2%.
The rotavirus vaccine is good value for money. Findings from this study offer evidence on potential economic benefits as well as the required budget for different rotavirus vaccination programs, which could be useful for future planning related to rotavirus vaccine coverage in Burundi after graduation from GAVI.
在布隆迪，腹泻是五岁以下儿童死亡的第三大原因。本研究对布隆迪的轮状病毒疫苗接种计划进行了经济分析。
建立了马尔可夫模型，以模拟 2019 年出生队列的临床和经济结果，为期 5 年。收集了经验成本数据。对世卫组织批准的 4 种轮状病毒疫苗的每例发作避免的成本效益比（ICER）、每例死亡避免的 ICER、每例残疾调整生命年（DALY）避免的 ICER、净现值和预算影响进行了估计。进行了单因素敏感性分析和概率敏感性分析以及阈值分析。
在基本情况下，虽然世卫组织批准的 4 种轮状病毒疫苗均具有成本效益（ICER<3 个国内生产总值（GDP）/人），但从提供者和社会角度来看，其中 3 种疫苗（即 Rotarix、Rotavac 和 Rotasiil）非常具有成本效益（ICER<1 个 GDP/人）。当 Rotarix、RotaTeq、Rotavac 和 Rotasiil 的价格分别上涨至 5.09 美元、3.16 美元、3.89 美元和 2.69 美元时，疫苗仍非常具有成本效益。概率敏感性分析表明，Rotarix、RotaTeq、Rotavac 和 Rotasiil 的疫苗接种计划在 93.8%、27%、99.1%和 92.7%的概率下具有成本效益。所有疫苗接种计划均具有成本效益，净现值在 5214912 美元至 11135997 美元之间。根据盈亏平衡价格估计，运行疫苗接种计划所需的预算在 5 年内为 42249498 美元至 53487935 美元之间。与 2019 年布隆迪的国内生产总值相比，这些都不到 2%。
轮状病毒疫苗物有所值。本研究的结果提供了有关潜在经济效益的证据，以及不同轮状病毒疫苗接种计划所需的预算，这对于布隆迪在获得 GAVI 资助后扩大轮状病毒疫苗覆盖范围的未来规划可能具有参考价值。
