Cost- effectiveness analysis of vaccination against rotavirus in Germany

BACKGROUND Rotavirus is the leading cause of acute gastroenteritis (RVGE) in children aged up to 5 years in industrial countries. Since 2006,there have been vaccinations available against RVGA in Germany. This analysis evaluated the cost- effectiveness of general vaccination against rotavirus in Germany paid by the national health insurance. METHODS The analyses were conducted from the perspective of the national healthcare system. The model followed the cohort of 685.795 children, who were born in Germany in 2005 over the first 60 month of live. We constructed a Markov model in Excel® software using one month cycles, to compare a vaccination program with conventional treatment. In each cycle of the model, individuals resided in one of four health states, to which costs(C) and utilities(U) were assigned: health( C=0€, U=1), death(C=0€,U=0) GP visits (C=110€,U=0,25) and hospitalization (C=1545 €, U=0,25). RESULTS Under base case assumptions, a vaccination program would cost the health care system 39.711€ per QALY gained. Univariate sensitivity analyses showed that utility scores of the health states, price of vaccines and transition probabilities were the parameter of the largest impact on the cost- effectiveness. In a rollback procedure we found out, that a vaccination program becomes cost neutral at a price of 28,35€ for a full immunization. DISCUSSION Immunization could reduce the burden of RVGE but is unlikely to be deemed cost effective unless the vaccine is competitively priced.