| Titre : | Cost-effectiveness analysis of a rotavirus immunization program for the United States. (1998) |
| Auteurs : | A.W. TUCKER ; J.S. BRESEE ; R.I. GLASS ; A.C. HADDIX ; R.C. HOLMAN ; U.D. PARASHAR ; Viral Gastroenteritis Section. Respiratory and Enteric Viruses Branch. Atlanta Ga. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 279, n° 17, 1998) |
| Pagination : | 1371-1376 |
| Langues: | Anglais |
| Mots-clés : | Etats Unis ; Amérique du Nord ; Amérique ; Programme élargi vaccination ; Programme santé ; Prévention santé ; Analyse coût efficacité ; Vaccination ; Virus ; Lutte contre maladie diarrhéique ; Diarrhée ; Economie santé ; Politique santé ; Nourrisson ; Homme ; Appareil digestif [pathologie] ; Intestin [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST c26YR0xT. Diffusion soumise à autorisation]. Context-Rotavirus is the most common cause of severe diarrhea in children, and a live, oral vaccine may soon be licensed for prevention. Objective-To estimate the economic impact of a national rotavirus immunization program in the United States. Design-Cost-effectiveness was analyzed from the perspectives of the health care system and society. A decision tree used estimates of disease burden, costs, vaccine coverage, efficacy, and price obtained from published and unpublished sources. Intervention-The proposed vaccine would be administered to infants at ages 2,4, and 6 months as part of the routine schedule of childhood immunizations. Main Outcome Measures-Total costs, outcomes prevented, and incremental cost-effectiveness. Results-A routine, universal rotavirus immunization program would prevent 1.08 million cases of diarrhea, avoiding 34 000 hospitalizations, 95 000 emergency department visits, and 227 000 physician visits in the first 5 years of life. At $20 per dose, the program would cost $289 million and realize a net loss of $107 million to the health care system-$103 per case prevented. The program would provide a net savings of $296 million to society. Threshold analysis identified a break-even price per dose of $9 for the health care system and $51 for the societal perspective. Greater disease burden and greater vaccine efficacy and lower vaccine price increased cost-effectiveness. (...) |
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