Cost effectiveness analysis of rotavirus vaccination in Indonesia
Rotavirus (RV) remains the most common cause of morbidity and mortality due to acute gastroenteritis (AGE) in children under five. In Indonesia, RV is responsible for 60 % of severe AGE and 40 % of non-severe AGE in these children. This study assessed the cost-effectiveness of introduction of rotavi...
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| Veröffentlicht in: | Vaccine 2025-01, Vol.43 (Pt 2), p.126478, Article 126478 |
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| creator | Thobari, Jarir At Watts, Emma Carvalho, Natalie Haposan, Jonathan Hasian Clark, Andrew Debellut, Frédéric Mulyadi, Asal Wahyuni Erlin Sundoro, Julitasari Nadjib, Mardiati Hadinegoro, Sri Redzeki Bines, Julie Soenarto, Yati |
| description | Rotavirus (RV) remains the most common cause of morbidity and mortality due to acute gastroenteritis (AGE) in children under five. In Indonesia, RV is responsible for 60 % of severe AGE and 40 % of non-severe AGE in these children. This study assessed the cost-effectiveness of introduction of rotavirus vaccines (RVV) into the National Immunization Program in Indonesia.
We conducted a cost-effectiveness analysis (CEA) of RVV introduction in Indonesia, assuming a three-dose vaccine schedule based on the planned introduction proposed by the Strategic Advisory Group of Experts on Immunization. The analysis involved an initial introduction of an imported RVV (Rotavac®, Bharat Biotech, India) followed by a staged implementation of the locally produced RVV (Bio Farma, Indonesia) from both health system and societal perspectives. The primary outcome measure was the incremental cost (2019 USD) per disability-adjusted life year (DALY) averted, compared to no vaccination. We took model inputs from an Indonesian cost-of-illness study, national information systems and scientific literature, covering disease incidence, hospitalization, mortality, healthcare costs, and vaccine related factors. Our analyses included univariate and probabilitistic sensitivity analyses to assess various parameters.
The cost of a 10-year vaccination program is 82.6 million USD and can potentially prevent 7.3 million cases of rotavirus and 0.42 million DALYs. From a societal perspective, the incremental cost-effectiveness ratio (ICER) for the staged program is 464 USD per DALY averted (12 % of Indonesia's gross domestic product (GDP) per capita). From a healthcare sector perspective, ICER is similar at 479 USD (13 % GDP per capita).
The introduction of RVV into the National Immunization Program is likely to be highly cost-effective in Indonesia.
This work was supported by funding agreement with the Murdoch Children's Research Institute (MCRI), PATH, and the Indonesian Technical Advisory Group on Immunization (ITAGI). |
| doi_str_mv | 10.1016/j.vaccine.2024.126478 |
| format | Article |
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We conducted a cost-effectiveness analysis (CEA) of RVV introduction in Indonesia, assuming a three-dose vaccine schedule based on the planned introduction proposed by the Strategic Advisory Group of Experts on Immunization. The analysis involved an initial introduction of an imported RVV (Rotavac®, Bharat Biotech, India) followed by a staged implementation of the locally produced RVV (Bio Farma, Indonesia) from both health system and societal perspectives. The primary outcome measure was the incremental cost (2019 USD) per disability-adjusted life year (DALY) averted, compared to no vaccination. We took model inputs from an Indonesian cost-of-illness study, national information systems and scientific literature, covering disease incidence, hospitalization, mortality, healthcare costs, and vaccine related factors. Our analyses included univariate and probabilitistic sensitivity analyses to assess various parameters.
The cost of a 10-year vaccination program is 82.6 million USD and can potentially prevent 7.3 million cases of rotavirus and 0.42 million DALYs. From a societal perspective, the incremental cost-effectiveness ratio (ICER) for the staged program is 464 USD per DALY averted (12 % of Indonesia's gross domestic product (GDP) per capita). From a healthcare sector perspective, ICER is similar at 479 USD (13 % GDP per capita).
The introduction of RVV into the National Immunization Program is likely to be highly cost-effective in Indonesia.
This work was supported by funding agreement with the Murdoch Children's Research Institute (MCRI), PATH, and the Indonesian Technical Advisory Group on Immunization (ITAGI).</description><identifier>ISSN: 0264-410X</identifier><identifier>ISSN: 1873-2518</identifier><identifier>EISSN: 1873-2518</identifier><identifier>DOI: 10.1016/j.vaccine.2024.126478</identifier><identifier>PMID: 39500219</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Age ; Bio Farma rotavirus vaccine ; Child, Preschool ; Children ; Cost analysis ; Cost control ; Cost effectiveness ; Cost-Benefit Analysis ; Cost-Effectiveness Analysis ; Costs effectiveness ; Decision making ; Demography ; Developing countries ; Diarrhea ; Disability-Adjusted Life Years ; Fatalities ; Funding ; Gastroenteritis ; Gastroenteritis - economics ; Gastroenteritis - epidemiology ; Gastroenteritis - prevention & control ; Gastroenteritis - virology ; GDP ; Gross Domestic Product ; Health care ; Health care expenditures ; Humans ; Immunization ; Immunization Programs - economics ; Indonesia ; Indonesia - epidemiology ; Infant ; Information systems ; International organizations ; LDCs ; Life expectancy ; Morbidity ; Mortality ; Parameter sensitivity ; Per capita ; Rotavac ; Rotavirus ; Rotavirus - immunology ; Rotavirus Infections - economics ; Rotavirus Infections - epidemiology ; Rotavirus Infections - prevention & control ; Rotavirus vaccines ; Rotavirus Vaccines - administration & dosage ; Rotavirus Vaccines - economics ; Rotavirus Vaccines - immunology ; Sensitivity analysis ; Surveillance ; Systematic review ; Vaccination - economics ; Vaccines ; Viruses</subject><ispartof>Vaccine, 2025-01, Vol.43 (Pt 2), p.126478, Article 126478</ispartof><rights>2024</rights><rights>Copyright © 2024. Published by Elsevier Ltd.</rights><rights>Copyright Elsevier Limited Jan 1, 2025</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c271t-3c3ba3d84027d0e2c2cea4f4ef35f1d9d7e4c397bb571d19d2749fbc0cae52163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.vaccine.2024.126478$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39500219$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thobari, Jarir At</creatorcontrib><creatorcontrib>Watts, Emma</creatorcontrib><creatorcontrib>Carvalho, Natalie</creatorcontrib><creatorcontrib>Haposan, Jonathan Hasian</creatorcontrib><creatorcontrib>Clark, Andrew</creatorcontrib><creatorcontrib>Debellut, Frédéric</creatorcontrib><creatorcontrib>Mulyadi, Asal Wahyuni Erlin</creatorcontrib><creatorcontrib>Sundoro, Julitasari</creatorcontrib><creatorcontrib>Nadjib, Mardiati</creatorcontrib><creatorcontrib>Hadinegoro, Sri Redzeki</creatorcontrib><creatorcontrib>Bines, Julie</creatorcontrib><creatorcontrib>Soenarto, Yati</creatorcontrib><title>Cost effectiveness analysis of rotavirus vaccination in Indonesia</title><title>Vaccine</title><addtitle>Vaccine</addtitle><description>Rotavirus (RV) remains the most common cause of morbidity and mortality due to acute gastroenteritis (AGE) in children under five. In Indonesia, RV is responsible for 60 % of severe AGE and 40 % of non-severe AGE in these children. This study assessed the cost-effectiveness of introduction of rotavirus vaccines (RVV) into the National Immunization Program in Indonesia.
We conducted a cost-effectiveness analysis (CEA) of RVV introduction in Indonesia, assuming a three-dose vaccine schedule based on the planned introduction proposed by the Strategic Advisory Group of Experts on Immunization. The analysis involved an initial introduction of an imported RVV (Rotavac®, Bharat Biotech, India) followed by a staged implementation of the locally produced RVV (Bio Farma, Indonesia) from both health system and societal perspectives. The primary outcome measure was the incremental cost (2019 USD) per disability-adjusted life year (DALY) averted, compared to no vaccination. We took model inputs from an Indonesian cost-of-illness study, national information systems and scientific literature, covering disease incidence, hospitalization, mortality, healthcare costs, and vaccine related factors. Our analyses included univariate and probabilitistic sensitivity analyses to assess various parameters.
The cost of a 10-year vaccination program is 82.6 million USD and can potentially prevent 7.3 million cases of rotavirus and 0.42 million DALYs. From a societal perspective, the incremental cost-effectiveness ratio (ICER) for the staged program is 464 USD per DALY averted (12 % of Indonesia's gross domestic product (GDP) per capita). From a healthcare sector perspective, ICER is similar at 479 USD (13 % GDP per capita).
The introduction of RVV into the National Immunization Program is likely to be highly cost-effective in Indonesia.
This work was supported by funding agreement with the Murdoch Children's Research Institute (MCRI), PATH, and the Indonesian Technical Advisory Group on Immunization (ITAGI).</description><subject>Age</subject><subject>Bio Farma rotavirus vaccine</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Cost analysis</subject><subject>Cost control</subject><subject>Cost effectiveness</subject><subject>Cost-Benefit Analysis</subject><subject>Cost-Effectiveness Analysis</subject><subject>Costs effectiveness</subject><subject>Decision making</subject><subject>Demography</subject><subject>Developing countries</subject><subject>Diarrhea</subject><subject>Disability-Adjusted Life Years</subject><subject>Fatalities</subject><subject>Funding</subject><subject>Gastroenteritis</subject><subject>Gastroenteritis - economics</subject><subject>Gastroenteritis - epidemiology</subject><subject>Gastroenteritis - prevention & control</subject><subject>Gastroenteritis - virology</subject><subject>GDP</subject><subject>Gross Domestic Product</subject><subject>Health care</subject><subject>Health care expenditures</subject><subject>Humans</subject><subject>Immunization</subject><subject>Immunization Programs - economics</subject><subject>Indonesia</subject><subject>Indonesia - epidemiology</subject><subject>Infant</subject><subject>Information systems</subject><subject>International organizations</subject><subject>LDCs</subject><subject>Life expectancy</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Parameter sensitivity</subject><subject>Per capita</subject><subject>Rotavac</subject><subject>Rotavirus</subject><subject>Rotavirus - immunology</subject><subject>Rotavirus Infections - economics</subject><subject>Rotavirus Infections - epidemiology</subject><subject>Rotavirus Infections - prevention & control</subject><subject>Rotavirus vaccines</subject><subject>Rotavirus Vaccines - administration & dosage</subject><subject>Rotavirus Vaccines - economics</subject><subject>Rotavirus Vaccines - immunology</subject><subject>Sensitivity analysis</subject><subject>Surveillance</subject><subject>Systematic review</subject><subject>Vaccination - economics</subject><subject>Vaccines</subject><subject>Viruses</subject><issn>0264-410X</issn><issn>1873-2518</issn><issn>1873-2518</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1LAzEQhoMotlZ_grLgxcvWTJJtdk8ixS8QvCh4C9lkAintRpPdgv_elK0evHgaGJ73HeYh5BzoHCgsrlfzrTbGdzhnlIk5sIWQ9QGZQi15ySqoD8mU5mUpgL5PyElKK0ppxaE5JhPeVJQyaKbkdhlSX6BzaHq_xQ5TKnSn11_JpyK4IoZeb30cUjGe070PXeG74qmzIdNen5Ijp9cJz_ZzRt7u716Xj-Xzy8PT8va5NExCX3LDW81tLSiTliIzzKAWTqDjlQPbWInC8Ea2bSXBQmOZFI1rDTUaKwYLPiNXY-9HDJ8Dpl5tfDK4XusOw5AUByYWNZdAM3r5B12FIeavdpTgjHNe8UxVI2ViSCmiUx_Rb3T8UkDVzrFaqb1jtXOsRsc5d7FvH9oN2t_Uj9QM3IwAZh1bj1El47EzaH3MmpUN_p8T37z_j38</recordid><startdate>20250101</startdate><enddate>20250101</enddate><creator>Thobari, Jarir At</creator><creator>Watts, Emma</creator><creator>Carvalho, Natalie</creator><creator>Haposan, Jonathan Hasian</creator><creator>Clark, Andrew</creator><creator>Debellut, Frédéric</creator><creator>Mulyadi, Asal Wahyuni Erlin</creator><creator>Sundoro, Julitasari</creator><creator>Nadjib, Mardiati</creator><creator>Hadinegoro, Sri Redzeki</creator><creator>Bines, Julie</creator><creator>Soenarto, Yati</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T5</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20250101</creationdate><title>Cost effectiveness analysis of rotavirus vaccination in Indonesia</title><author>Thobari, Jarir At ; Watts, Emma ; Carvalho, Natalie ; Haposan, Jonathan Hasian ; Clark, Andrew ; Debellut, Frédéric ; Mulyadi, Asal Wahyuni Erlin ; Sundoro, Julitasari ; Nadjib, Mardiati ; Hadinegoro, Sri Redzeki ; Bines, Julie ; Soenarto, Yati</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c271t-3c3ba3d84027d0e2c2cea4f4ef35f1d9d7e4c397bb571d19d2749fbc0cae52163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Age</topic><topic>Bio Farma rotavirus vaccine</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Cost analysis</topic><topic>Cost control</topic><topic>Cost effectiveness</topic><topic>Cost-Benefit Analysis</topic><topic>Cost-Effectiveness Analysis</topic><topic>Costs effectiveness</topic><topic>Decision making</topic><topic>Demography</topic><topic>Developing countries</topic><topic>Diarrhea</topic><topic>Disability-Adjusted Life Years</topic><topic>Fatalities</topic><topic>Funding</topic><topic>Gastroenteritis</topic><topic>Gastroenteritis - economics</topic><topic>Gastroenteritis - epidemiology</topic><topic>Gastroenteritis - prevention & control</topic><topic>Gastroenteritis - virology</topic><topic>GDP</topic><topic>Gross Domestic Product</topic><topic>Health care</topic><topic>Health care expenditures</topic><topic>Humans</topic><topic>Immunization</topic><topic>Immunization Programs - economics</topic><topic>Indonesia</topic><topic>Indonesia - epidemiology</topic><topic>Infant</topic><topic>Information systems</topic><topic>International organizations</topic><topic>LDCs</topic><topic>Life expectancy</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Parameter sensitivity</topic><topic>Per capita</topic><topic>Rotavac</topic><topic>Rotavirus</topic><topic>Rotavirus - immunology</topic><topic>Rotavirus Infections - economics</topic><topic>Rotavirus Infections - epidemiology</topic><topic>Rotavirus Infections - prevention & control</topic><topic>Rotavirus vaccines</topic><topic>Rotavirus Vaccines - administration & dosage</topic><topic>Rotavirus Vaccines - economics</topic><topic>Rotavirus Vaccines - immunology</topic><topic>Sensitivity analysis</topic><topic>Surveillance</topic><topic>Systematic review</topic><topic>Vaccination - economics</topic><topic>Vaccines</topic><topic>Viruses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thobari, Jarir At</creatorcontrib><creatorcontrib>Watts, Emma</creatorcontrib><creatorcontrib>Carvalho, Natalie</creatorcontrib><creatorcontrib>Haposan, Jonathan Hasian</creatorcontrib><creatorcontrib>Clark, Andrew</creatorcontrib><creatorcontrib>Debellut, Frédéric</creatorcontrib><creatorcontrib>Mulyadi, Asal Wahyuni Erlin</creatorcontrib><creatorcontrib>Sundoro, Julitasari</creatorcontrib><creatorcontrib>Nadjib, Mardiati</creatorcontrib><creatorcontrib>Hadinegoro, Sri Redzeki</creatorcontrib><creatorcontrib>Bines, Julie</creatorcontrib><creatorcontrib>Soenarto, Yati</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Vaccine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thobari, Jarir At</au><au>Watts, Emma</au><au>Carvalho, Natalie</au><au>Haposan, Jonathan Hasian</au><au>Clark, Andrew</au><au>Debellut, Frédéric</au><au>Mulyadi, Asal Wahyuni Erlin</au><au>Sundoro, Julitasari</au><au>Nadjib, Mardiati</au><au>Hadinegoro, Sri Redzeki</au><au>Bines, Julie</au><au>Soenarto, Yati</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost effectiveness analysis of rotavirus vaccination in Indonesia</atitle><jtitle>Vaccine</jtitle><addtitle>Vaccine</addtitle><date>2025-01-01</date><risdate>2025</risdate><volume>43</volume><issue>Pt 2</issue><spage>126478</spage><pages>126478-</pages><artnum>126478</artnum><issn>0264-410X</issn><issn>1873-2518</issn><eissn>1873-2518</eissn><abstract>Rotavirus (RV) remains the most common cause of morbidity and mortality due to acute gastroenteritis (AGE) in children under five. In Indonesia, RV is responsible for 60 % of severe AGE and 40 % of non-severe AGE in these children. This study assessed the cost-effectiveness of introduction of rotavirus vaccines (RVV) into the National Immunization Program in Indonesia.
We conducted a cost-effectiveness analysis (CEA) of RVV introduction in Indonesia, assuming a three-dose vaccine schedule based on the planned introduction proposed by the Strategic Advisory Group of Experts on Immunization. The analysis involved an initial introduction of an imported RVV (Rotavac®, Bharat Biotech, India) followed by a staged implementation of the locally produced RVV (Bio Farma, Indonesia) from both health system and societal perspectives. The primary outcome measure was the incremental cost (2019 USD) per disability-adjusted life year (DALY) averted, compared to no vaccination. We took model inputs from an Indonesian cost-of-illness study, national information systems and scientific literature, covering disease incidence, hospitalization, mortality, healthcare costs, and vaccine related factors. Our analyses included univariate and probabilitistic sensitivity analyses to assess various parameters.
The cost of a 10-year vaccination program is 82.6 million USD and can potentially prevent 7.3 million cases of rotavirus and 0.42 million DALYs. From a societal perspective, the incremental cost-effectiveness ratio (ICER) for the staged program is 464 USD per DALY averted (12 % of Indonesia's gross domestic product (GDP) per capita). From a healthcare sector perspective, ICER is similar at 479 USD (13 % GDP per capita).
The introduction of RVV into the National Immunization Program is likely to be highly cost-effective in Indonesia.
This work was supported by funding agreement with the Murdoch Children's Research Institute (MCRI), PATH, and the Indonesian Technical Advisory Group on Immunization (ITAGI).</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>39500219</pmid><doi>10.1016/j.vaccine.2024.126478</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0264-410X |
| ispartof | Vaccine, 2025-01, Vol.43 (Pt 2), p.126478, Article 126478 |
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| subjects | Age Bio Farma rotavirus vaccine Child, Preschool Children Cost analysis Cost control Cost effectiveness Cost-Benefit Analysis Cost-Effectiveness Analysis Costs effectiveness Decision making Demography Developing countries Diarrhea Disability-Adjusted Life Years Fatalities Funding Gastroenteritis Gastroenteritis - economics Gastroenteritis - epidemiology Gastroenteritis - prevention & control Gastroenteritis - virology GDP Gross Domestic Product Health care Health care expenditures Humans Immunization Immunization Programs - economics Indonesia Indonesia - epidemiology Infant Information systems International organizations LDCs Life expectancy Morbidity Mortality Parameter sensitivity Per capita Rotavac Rotavirus Rotavirus - immunology Rotavirus Infections - economics Rotavirus Infections - epidemiology Rotavirus Infections - prevention & control Rotavirus vaccines Rotavirus Vaccines - administration & dosage Rotavirus Vaccines - economics Rotavirus Vaccines - immunology Sensitivity analysis Surveillance Systematic review Vaccination - economics Vaccines Viruses |
| title | Cost effectiveness analysis of rotavirus vaccination in Indonesia |
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