Evaluating rotavirus vaccination in England and Wales. Part II. The potential cost-effectiveness of vaccination

Aim: Rotavirus is the leading cause of acute gastroenteritis in children. Two rotavirus vaccines (RotaTeq^® and Rotarix^®) have recently completed clinical trials. We investigated whether routine infant immunisation with either vaccine can be cost effective. Methods: We compared costs and outcomes of vaccination using a cohort model, following children over the first 5 years of life. We estimated health provider costs, economic costs and quality adjusted life years (QALYs) lost due to rotavirus-related deaths, hospital admissions, nosocomial infections, accident and emergency attendances, general practioner consultations and calls to NHS Direct. Results: Under base case assumptions, a programme using RotaTeq^® (priced at £25 a dose) would cost the health provider £79,900 per QALY gained. Using Rotarix^® (priced at £35 a dose) would cost £61,000 per QALY gained. Univariate and multivariate sensitivity analysis indicate that at these prices an immunisation programme would be unlikely to be cost-effective for any realistic value of the key parameters. Conclusions: Rotavirus immunisation could reduce the substantial short-term morbidity burden due to rotavirus, but is unlikely to be deemed cost effective unless the vaccine is competitively priced.