An update of cost-effectiveness of rotavirus vaccination in indonesia: Takinga birth-dose vaccination strategy into account

A.A. Suwantika, D. Setiawan, J. Atthobari, M.J. Postma

Research output: Contribution to journalMeeting AbstractAcademic


Objectives: Rotavirus infection was reported as the major cause of severe diarrhea in children under 5-years-old in Indonesia. A low cost rotavirus vaccine to protect infants from birth has been developed for developing countries, such as Indonesia. This study aims to update our initial analysis on the cost-effectiveness of rotavirus vaccination in Indonesia, taking a birth-dose vaccination strategy explicitly into account. Methods: An age-structured cohort model was developed for the 2013 Indonesia birth cohort. Applying different rotavirus vaccine efficacies for formula-fed and breastfed infants, we compared two vaccination strategies: (i) three-dose schedule at 2, 3 and 4 months of age, and (ii) three-dose schedule at 0, 1, and 2 months of age. We applied a 5-year-time-horizon with 1 monthly analytical cycles for children less than 1 year of age and annually thereafter. Also, we used Monte Carlo simulations to examine the economic acceptability and affordability of the rotavirus vaccination. Results: Rotavirus vaccination would reduce rotavirus-diarrhea cases in children under 5-years-old by 475,806 and 489,259 cases for the first and second strategies, respectively. Considering amarket price of US$ 5 per dose, the Indonesian government would require budgets of US$ 65.0 million and US$ 65.3 million for the first and second strategies, respectively.The incremental cost-effectiveness ratios wereUS$ 150 and US$ 146for the first and second strategies, respectively, which were much lower than the 2013 Indonesian Gross Domestic Product (GDP) per capita of US$ 4,790. Conclusions: The implementation of a birth-dose rotavirusvaccination strategy in Indonesia would be more cost-effective than a later vaccination schedule. The mortality rate and vaccine price were the most influential parameters impacting the costeffectiveness results.
Original languageEnglish
Pages (from-to)A751-A752
Number of pages2
JournalValue in Health
Issue number7
Publication statusPublished - 1-Nov-2014


  • vaccine
  • Rotavirus vaccine
  • vaccination
  • cost effectiveness analysis
  • Rotavirus
  • Indonesia
  • human
  • child
  • drug dose regimen
  • diarrhea
  • infant
  • gross national product
  • budget
  • government
  • Monte Carlo method
  • model
  • parameters
  • mortality
  • developing country
  • Rotavirus infection

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