Journal
BMJ OPEN
Volume 12, Issue 10, Pages -Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2022-061673
Keywords
Health economics; Health policy; Public health; Paediatric infectious disease & immunisation
Categories
Funding
- Bill & Melinda Gates Foundation [OPP1147721]
- Medecins Sans Frontieres (MSF)-Operational Center Geneva
- Kavli Foundation, Norway
- Bill and Melinda Gates Foundation [OPP1147721] Funding Source: Bill and Melinda Gates Foundation
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This study evaluates the cost-effectiveness of different rotavirus vaccines in Niger and suggests that ROTAVAC is likely the most cost-effective option. ROTAVAC can prevent a significant number of cases and child deaths while providing similar or higher benefits at a lower cost.
Objectives To evaluate the cost-effectiveness of alternative rotavirus vaccines in Niger, using UNIVAC, a proportionate outcomes model. Setting The study leverages global, regional and local data to inform cost-effectiveness modelling. Local data were collected as part of a clinical trial taking place in the Madarounfa district, Maradi region, Niger. Participants The study models impact of infants vaccination on rotavirus gastroenteritis in children under 5 years of age. Interventions We compared the use of ROTARIX (GlaxoSmithKline, Belgium), ROTAVAC (Bharat Biotech, India) and ROTASIIL (Serum Institute, India) to no vaccination and to each other over a 10-year period starting in 2021. Results We estimated that ROTARIX, ROTAVAC and ROTASIIL would each prevent 13 million cases and 20 000 deaths of children under 5 years over a 10-year period in Niger. Compared with no vaccination, the cost to avert a disability-adjusted life-year was US$146 with ROTARIX, US$107 with ROTASIIL and US$76 with ROTAVAC from the government perspective. ROTAVAC dominated ROTARIX and ROTASIIL (eg, provided similar or higher benefits at a lower cost) and had 90% chance to be cost-effective at a US$100 willingness-to-pay threshold. Conclusions This study can inform decision-making around rotavirus vaccination policy in Niger, demonstrating that ROTAVAC is likely the most cost-effective option. Alternative products (ROTASIIL and ROTARIX) may also be considered by decision-makers if they are priced more competitively, or if their cold chain requirements could bring additional economic benefits.
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