Updating and Refining of Economic Evaluation of Rotavirus Vaccination in Spain: A Cost-Utility and Budget Impact Analysis

Viruses. 2024 Jul 25;16(8):1194. doi: 10.3390/v16081194.

Abstract

Two vaccines against rotavirus diseases, Rotarix® and RotaTeq®, are being marketed in Spain; but rotavirus is not presently among the diseases covered by universal vaccination in Spain. The aim of this study was to assess the efficiency of extending Spain's current targeted rotavirus vaccination strategy including only preterm babies, to a policy of universal vaccination. A de novo cohort-based Markov model was built to evaluate the efficiency of three compared rotavirus vaccination strategies in Spain: targeted, universal, and no vaccination. Using Rotarix® or RotaTeq®, we compared the cost-utility of these strategies from both a societal perspective and Spanish National Health System (SNHS) perspective. The model represents the most important clinical events conceivably linked to rotavirus infection. Efficacy, effectiveness, safety, costs, and utilities were identified by systematic reviews. Incremental cost-utility ratio (ICUR) is EUR 23,638/QALY (Quality-Adjusted Life Year) for targeted vaccination with Rotarix® compared with no vaccination. The ICUR for the rest of the strategies evaluated are above EUR 30,000/QALY. The sensitivity analysis shows price as the only parameter that could make the universal vaccination strategy efficient. Considering a threshold of EUR 25,000/QALY, only targeted vaccination with Rotarix® would be efficient from societal perspective. Price drops of 36.9% for Rotarix® and 44.6% for RotaTeq® would make universal vaccination efficient.

Keywords: Markov model; budget impact; cost-effectiveness; cost–utility; economic evaluation; rotavirus vaccine.

MeSH terms

  • Budgets
  • Child, Preschool
  • Cost-Benefit Analysis*
  • Humans
  • Infant
  • Infant, Newborn
  • Markov Chains
  • Quality-Adjusted Life Years*
  • Rotavirus / immunology
  • Rotavirus Infections* / economics
  • Rotavirus Infections* / prevention & control
  • Rotavirus Vaccines* / administration & dosage
  • Rotavirus Vaccines* / economics
  • Rotavirus Vaccines* / immunology
  • Spain
  • Vaccination* / economics
  • Vaccines, Attenuated* / administration & dosage
  • Vaccines, Attenuated* / economics
  • Vaccines, Attenuated* / immunology

Substances

  • Rotavirus Vaccines
  • Vaccines, Attenuated
  • RIX4414 vaccine
  • RotaTeq

Grants and funding

This work was partially supported by a grant from the Carlos III Institute of Health through the RICAPPS (RD21CIII/0003/0002) and the annual program of the Spanish Network of Health Technology Assessment Agencies and National Health System Services (Red Española de Agencias de Evaluación de Tecnologías Sanitarias y Prestaciones del Sistema Nacional de Salud/RedETS), funded by the Spanish Ministry of Health.