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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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