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The most recent version of this article was published on 1 January 2008

Arch Dis Child. Published Online First: 12 September 2007. doi:10.1136/adc.2007.117879
Copyright © 2007 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health

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Original articles

Rotavirus vaccination for Hong Kong children – An economic evaluation from the Hong Kong government perspective

Anthony MH Ho 1*, Edmund Anthony Nelson 1 and Damian G Walker 2

1 The Chinese University of Hong Kong, Hong Kong
2 The Johns Hopkins University, United States

* To whom correspondence should be addressed. E-mail: hoamh{at}yahoo.com.

Accepted 5 September 2007


*   Abstract

Aims: To perform an economic analysis of a 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 the age of five 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 costs would quickly lead to an incremental cost effectiveness ratio that exceeds that of the gross national product per capita, if indeed the mortality rate of rotavirus gastroenteritis is 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.


Keywords: Hong Kong, cost-effectiveness analysis, gastroenteritis, immunization, rotavirus







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