Key result
Including Rotateq in China's national immunization program projects a ~63% reduction in rotavirus cases.
Why the study?
In China, progress to include the rotavirus vaccine in the national immunization program is slow, with available vaccines currently provided only through the private market.
Does including rotavirus vaccines in the national immunization program improve health outcomes and cost-effectiveness compared to private market provision in the 2019 birth cohort in China?
Does including rotavirus vaccines in the national immunization program improve health outcomes and cost-effectiveness compared to private market provision in the 2019 birth cohort in China?
Introducing rotavirus vaccines into China's national immunization program is projected to be highly cost-effective and significantly reduce disease burden compared to private market provision.
May support NIP inclusion of Rotateq or Rotarix in China at GDP threshold; leaves open price sensitivity and lower WTP thresholds for adoption.
In China, progress to include the RV vaccine in the national immunization program (NIP) is slow. The only two vaccines, the Lanzhou lamb rotavirus vaccine (LLR) and Rotateq, are provided through the private market. This study aims to assess the health impact and cost-effectiveness of using three vaccines in the NIP, Rotateq, Rotarix, and LLR, compared to the status quo. A decision-tree Markov model was adopted to follow the 2019 birth cohort, and a societal perspective was used. Input parameters were based on the latest local data when possible. Outcomes included cases and deaths averted, quality-adjusted life years (QALYs) gained, and incremental cost-effectiveness ratios (ICER). Sensitivity analyses and scenario analyses to consider herd immunity and vaccine price reduction were performed. Including Rotateq in the NIP was projected to prevent 348 million RVGE cases (62.6% reduction) and 4251 deaths (72.6% reduction) compared to the status quo. Rotarix through the NIP would prevent 48.7% of cases and 63.2% of deaths, and LLR would avert 20.3% of cases and 22.4% of deaths. The ICERs per QALY gained were US$ 8833 for Rotateq through the NIP, US$ 9503 for Rotarix, and US$ 26,759 for LLR. In uncertainty analyses, the reduction of vaccine prices and the incorporation of herd immunity further improved the cost-effectiveness of the NIPs, especially Rotateq or Rotarix. In conclusion, introducing the RV vaccine in China's NIP is expected to be cost-effective compared to the GDP per capita. Reducing vaccine prices and adopting vaccines with better efficacy would be the future focus.
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Wang et al. (2022) studied Rotavirus gastroenteritis. Rotavirus vaccines (Rotateq, Rotarix, LLR) in the national immunization program vs. Status quo (private market provision) was evaluated on Cases and deaths averted, quality-adjusted life years (QALYs) gained, and incremental cost-effectiveness ratios (ICER). Including Rotateq in China's national immunization program was projected to prevent 348 million rotavirus cases (62.6% reduction) with an ICER of US$ 8833 per QALY gained compared to the status quo.
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