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Volume 20, Number 1—January 2014
Research

Dynamic Modeling of Cost-effectiveness of Rotavirus Vaccination, Kazakhstan

Birgitte Freiesleben de BlasioComments to Author , Elmira Flem, Renat Latipov, Ajnagul Kuatbaeva, and Ivar Sønbø Kristiansen
Author affiliations: Norwegian Institute of Public Health, Oslo, Norway (B. Freiesleben de Blasio, E. Flem); University of Oslo, Norway (B. Freiesleben de Blasio, I.S. Kristiansen); Research Institute of Virology, Tashkent, Republic of Uzbekistan (R. Latipov); Scientific-Practical Centre of Epidemiologic Surveillance, Almaty, Republic of Kazakhstan (A. Kuatbaeva)

Main Article

Table 4

Estimated projected costs and avoided health outcomes of rotavirus vaccination program in Kazakhstan, 2012–2031

Outcome
No vaccination
Base case, 90% vaccine coverage, 1-y vaccination protection

Scenario A, 80% vaccine coverage, 1-y vaccination protection

Scenario B, 100% vaccine coverage, 1-y vaccination protection
Mean
Low
High
Mean
Low
High
Mean
Low
High
Avoided outcomes, undiscounted
Fatal cases 1,310 880 776 1,004 777 681 890 985 876 1 114
In-hospital care 77,205 51,891 46,094 57,971 45,802 40,436 51,447 58,086 52,038 64,396
Out-patient visits 550,896 370,268 211,825 541,919 326,820 185,825 480,935 414,473 239,145 601,983
Home care episodes 2,675,456 1,344,747 640,836 2,112,400 1,163,780 552,160 1,835,487 1,544,096 740,039 2,412,843
Life years gained

54,784
48,304
62,442

48,356
42,375
55,416

61,325
54,534
69,363
Vaccination 530.7 530.7 530.7 471.9 471.9 471.9 589.6 589.6 589.6
In-hospital care −25.7 −18.9 −16.8 −21.2 −16.7 −14.7 −18.7 −21.2 −18.9 −23.5
Out-hospital care −16.3 −12.0 −6.9 −17.6 −10.6 −6.0 −15.6 −13.4 −7.8 −19.5
Homecare −8.5 −4.7 −2.2 −7.4 −4.1 −1.9 −6.4 −5.4 −2.6 −8.4
Indirect costs −179.4 −122.3 −88.4 −159.7 −107.4 −77.4 −140.9 −137.7 −100.3 −178.9
Total net costs
229.9
372.8
416.4
325.0

333.1
371.8
290.2

411.9
460.1
359.3

Incremental cost-effectiveness ratios, societal perspective
Discounted 3%
NA
18,044
22,779
13,854

18,280
27,991
13,955

17,775
22,250
13,768

Incremental cost-effectiveness ratios, health care perspective
Discounted 3%
NA
23,892
27,573
20,557

24,102
23,210
20,620

23,658
27,061
20,526

Threshold prices, 3% discounting
Medical break-even price† NA $2.78 $2.01 $3.62 $2.78 $1.96 $3.60 $2.83 $2.05 $3.65

*Negative values indicate prevented or avoided costs. NA, not applicable.
†The price per vaccine dose at which the vaccinations costs are offset by cost saving generated from lower morbidity and mortality rates.

Main Article

Page created: January 03, 2014
Page updated: January 03, 2014
Page reviewed: January 03, 2014
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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