Rotavirus disease in Uzbekistan: Cost-effectiveness of a new vaccine

We evaluated the cost-effectiveness of rotavirus vaccination in Uzbekistan from the healthcare system and societal perspectives. Disease burden was estimated using national statistics on hospitalizations and deaths, and international estimates of under-five mortality. Without vaccination, the risk for rotavirus hospitalization by age 5 is 10 per 1000 children. Rotavirus hospitalizations cost US$406,000 annually, of which US$360,000 (89%) is for medical expenses and US$46,000 (11%) is for non-medical and indirect costs. Rotavirus mortality rate at 0.7 per 1000 derived from national data was three-fold lower than the same rate calculated from international estimates of under-five mortality. Rotavirus vaccination could reduce hospitalizations and deaths by 91% and avert US$370,000 in hospitalization costs alone. Vaccination would be cost-effective with vaccine prices in a range of US$2-25 per child. However, the cost-effectiveness is greatly influenced by mortality, vaccine price and vaccine efficacy. (c) 2006 Elsevier Ltd. All rights reserved.