Impact and cost-effectiveness of rotavirus vaccination in Niger: a modelling study evaluating alternative rotavirus vaccines. Issue 10 (5th October 2022)

• Record Type: Journal Article
• Authors: Debellut, Frédéric; Tang, Kevin; Clark, Andrew; Pecenka, Clint; Assao, Bachir; Guindo, Ousmane; Grais, Rebecca F; Isanaka, Sheila
• Is Part Of: BMJ open. Volume 12:Issue 10(2022)
• Publication Date: 2022-10-05
• Subjects: Health economics -- Health policy -- Public health -- Paediatric infectious disease & immunisation; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2022-061673
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : 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.