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Rotavirus vaccination for Hong Kong children: an economic evaluation from the Hong Kong Government perspective

¹ Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, PRC
² Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong SAR, PRC
³ Department of International Health, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, MD, USA

Correspondence to:
Professor A Ho, Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR, PRC; hoamh{at}yahoo.com

Aims: To perform an economic analysis of government-funded universal rotavirus vaccination in Hong Kong from the government’s perspective.

Methods: A Markov model of costs and effects (disability averted) associated with universal vaccination was compared with no vaccination. In both strategies, newborns were studied until 5 years of age or until they died, using cost, probability and utility data from the literature. The potential cost savings and cost effectiveness of vaccination were calculated and their sensitivities to changes in vaccine and health care costs, presumed decline in vaccine efficacy over time, and the use of discounting and age weights were determined.

Results: Depending on assumptions, the new rotavirus vaccines would be cost saving to the Hong Kong Government if they cost less than US$40–92 per course. Higher vaccine costs would quickly lead to an incremental cost-effectiveness ratio exceeding that of the gross national product per capita if the mortality rate of rotavirus gastroenteritis remained at zero.

Conclusions: Based on 2002 demographic, cost and morbidity data and reasonable uncertainty estimates of these variables, a universal rotavirus vaccination programme paid for by the Hong Kong Government is cost neutral at a per course vaccine cost of US$40–92. For a fixed vaccine cost, the potential savings and cost effectiveness of the vaccine increase with higher estimated health care costs and vice versa.