Vaccine
Volume 35, Issue 2, Pages 201-410 (5 January 2017)
http://www.sciencedirect.com/science/journal/0264410X/35/2

Beyond expectations: Post-implementation data shows rotavirus vaccination is likely cost-saving in Australia
Original Research Article
Pages 345-352
J.F. Reyes, J.G. Wood, P. Beutels, K. Macartney, P. McIntyre, R. Menzies, N. Mealing, A.T. Newall
Abstract
Background
Universal vaccination against rotavirus was included in the funded Australian National Immunisation Program in July 2007. Predictive cost-effectiveness models assessed the program before introduction.
Methods
We conducted a retrospective economic evaluation of the Australian rotavirus program using national level post-implementation data on vaccine uptake, before-after measures of program impact and published estimates of excess intussusception cases. These data were used as inputs into a multi-cohort compartmental model which assigned cost and quality of life estimates to relevant health states, adopting a healthcare payer perspective. The primary outcome was discounted cost per quality adjusted life year gained, including or excluding unspecified acute gastroenteritis (AGE) hospitalisations.
Results
Relative to the baseline period (1997–2006), over the 6 years (2007–2012) after implementation of the rotavirus program, we estimated that ∼77,000 hospitalisations (17,000 coded rotavirus and 60,000 unspecified AGE) and ∼3 deaths were prevented, compared with an estimated excess of 78 cases of intussusception. Approximately 90% of hospitalisations prevented were in children Conclusion
The inclusion of herd impact and declines in unspecified AGE hospitalisations resulted in the value for money achieved by the Australian rotavirus immunisation program being substantially greater than predicted by pre-implementation models, despite the potential increased cases of intussusception. This Australian experience is likely to be relevant to high-income countries yet to implement rotavirus vaccination programs.

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