Economic analysis of rotavirus vaccination program in Burundi

Abstract

In Burundi, diarrhea is the third cause of mortality among children under five years of age. This study aimed to estimate the cost of diarrhea, assess the cost-effectiveness, cost-utility, cost-benefit and estimate the budget impact of the rotavirus vaccination program in Burundi. A Markov model was constructed to simulate both clinical and economic outcomes for Burundi 2019 birth cohort during 5 years. Empirical costing data were collected. Cost per episode and death averted, incremental cost-effectiveness ratio, net present value and budget impact were calculated for each brand of rotavirus vaccine with WHO prequalification. Univariate and probabilistic sensitivity analysis, as well as threshold analysis were performed. The average cost per episode of diarrhea was estimated to 46,500 BIF and 70,970 BIF from provider and societal perspective, respectively. From societal perspective, the cost per DALY avoided was estimated to 191,613 BIF, 506,473 BIF, 145,313 BIF, and 248,777 BIF for Rotarix, RotaTeq, Rotavac, and Rotasiil, respectively. From provider perspective, the cost per DALY avoided was estimated to 254,775 BIF, 549,703 BIF, 189,950 BIF, and 284,817 BIF, respectively. Based on WHO criteria for cost-effective threshold, Rotarix, Rotavac, and Rotasiil vaccines were highly cost-effective.