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Economic Evaluation of Human Rotavirus Vaccine in Thailand

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Abstract

Introduction

Rotavirus gastroenteritis is the leading cause of severe diarrhoea among young children < 5 years old. Previous cost-effectiveness analyses on rotavirus (RV) vaccination in Thailand have generated conflicting results. The aim of this current study is to evaluate the economic impact of introducing RV vaccination in Thailand, using updated Thai epidemiological and cost data.

Methods

Both cost-utility analysis (CUA) and budget impact analysis (BIA) of human rotavirus vaccine (HRV) under a universal mass vaccination (UMV) programme were conducted. A published static, deterministic, cross-sectional population model was adapted to assess costs and health outcomes associated with RV vaccination among Thai children < 5 years old during 1 year for CUA and over a 5-year period (2019–2023) for BIA. Data identified through literature review were incorporated into the model after consultation with local experts. Base case CUA was conducted from a societal perspective with quality-adjusted life year (QALY) discounted at 3% annually. Scenario analyses as well as one-way and probabilistic sensitivity analyses were conducted to assess the robustness of the base case CUA results. Costs were updated to 2017.

Results

At 99% coverage, HRV vaccination would substantially reduce RV-related disease burden. With an incremental cost-effectiveness ratio (ICER) of Thai baht (THB) 49,923/QALY gained, HRV vaccination versus no vaccination was cost-effective when assessed against a local threshold of THB 160,000/QALY gained. Scenario and sensitivity analyses confirmed the cost-effectiveness with all resultant ICERs falling below the willingness-to-pay threshold. HRV use in the UMV programme was estimated to result in a net expenditure of about THB 255–281 million to the Thai government in the 5th year of the programme, depending on vaccine uptake.

Conclusion

HRV vaccination is estimated to be cost-effective in Thailand. The budget impact following inclusion of HRV into the UMV programme is expected to be partially offset by substantial reductions in RV-related disease costs.

Funding

GlaxoSmithKline Biologicals SA

GSK Study Identifier

HO-17-18213

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Acknowledgements

Trademark

Rotarix is a trademark of the GSK group of companies. Rotateq is a trademark of Merck & Co. Inc.

Funding

GlaxoSmithKline Biologicals SA was the funding source and was involved in all stages of the study conduct and analysis (GSK study identifier: HO-17-18213). GlaxoSmithKline Biologicals SA also took over all costs associated with the development and publication of the present manuscript. All authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and accuracy of the data analysis.

Medical writing, editorial, and other assistance

The authors thank Prof. Somsak Lolekha (Mahidol University, Thailand) and Claire Montante (GSK, Belgium) for their contribution to the study as well as Rebecca Crawford (GSK, Singapore) for her support during the publication development. The authors also thank Business & Decision Life Sciences platform for editorial assistance and manuscript coordination on behalf of GSK: Nathalie Arts coordinated manuscript development and editorial support and Sarah Fico provided medical writing support.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Wasana Prasitsuebsai is an employee of and holds shares in the GSK group of companies. Gyneth Lourdes Bibera is an employee of and holds shares in the GSK group of companies. Xu-Hao Zhang is an employee of and holds shares in the GSK group of companies. Kyu-Bin Oh is an employee of and holds shares in the GSK group of companies. Christa Lee is an employee of the GSK group of companies. Surasak Saokaew and Kirati Kengkla have nothing to disclose.

Compliance with Ethics Guidelines

This article does not contain any studies with human participants or animals performed by any of the authors.

Data Availability

GSK makes available anonymized individual participant data and associated documents from interventional clinical studies which evaluate medicines, upon approval of proposals submitted to http://www.clinicalstudydatarequest.com. To access data for other types of GSK sponsored research, for study documents without patient-level data and for clinical studies not listed, please submit an enquiry via the website.

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Authors and Affiliations

  1. Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand

    Surasak Saokaew & Kirati Kengkla

  2. Center of Pharmaceutical Outcomes Research (CPOR), Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand

    Surasak Saokaew

  3. Unit of Excellence on Herbal Medicine, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand

    Surasak Saokaew

  4. School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia

    Surasak Saokaew

  5. GSK, Bangkok, Thailand

    Wasana Prasitsuebsai & Kyu-Bin Oh

  6. GSK, Singapore, Singapore

    Gyneth Lourdes Bibera, Xu-Hao Zhang & Christa Lee

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  1. Surasak Saokaew
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Correspondence to Christa Lee.

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Saokaew, S., Prasitsuebsai, W., Bibera, G.L. et al. Economic Evaluation of Human Rotavirus Vaccine in Thailand. Infect Dis Ther 8, 397–415 (2019). https://doi.org/10.1007/s40121-019-0246-1

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