The Economic Burden of Rotavirus Diarrhea: Taiwan Perspectives

  • Kow-Tong Chen


Worldwide, rotavirus is the principal cause of diarrheal illness in young children. Rotavirus  infection causes significant morbidity and mortality, often inflicting emotional distress and financial burden on the family and the society.

Disease surveillance has revealed that the incidence of rotavirus infections in infants and young children is similar in both developing and developed countries. Despite so, the burden of mortality is most pronounced in the poorest countries with limited healthcare access, while morbidity is of greater significance in the developed countries. Asia’s diverse populations and economies therefore present a full spectrum of disease burden. The main drivers of rotavirus burden are direct costs (e.g., hospitalizations) and indirect costs (e.g., loss of productivity). Indirect costs are substantial in industrialized counties. The estimated annual social and medical costs due to rotavirus infections in the United States were over US $1 billion and US $264 million, respectively, demonstrating a clear emphasis of indirect over direct cost. In contrast, the estimated annual social and hospital costs for rotavirus-associated admission in Taiwan were US $13.3 million and US $10.4 million, respectively, showing the equivalence in direct and indirect cost burden.

Although few countries have evaluated its economic impact or considered the potential  cost effectiveness (CE) of rotavirus  universal mass vaccination (UMV), the magnitude of rotavirus disease burden is recognized. Rotavirus vaccine could markedly alleviate the ensuing disease toll on both society and the economy but to maximize its benefits, it will be important to increase its coverage.


Indirect Cost National Health Insurance Program Taiwan National Health Insurance Total Indirect Cost Sentinel Hospital 

List of Abbreviations:


 acute gastroenteritis


 Asian Rotavirus Surveillance Network


Bureau of National Health Insurance


cost effectiveness




 global alliance for vaccine and immunization

ICD-9 CM codes

International Classification of Disease, ninth edition, Clinical Modification Code (ICD-9 CM Code)


 length of stay


out-patient department


 oral rehydration therapy


reverse transcription-polymerase chain reaction


 sentinel hospital


universal mass vaccination


World Health Organization


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  • Kow-Tong Chen

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