Two RV vaccines have been licensed in Zhejiang province, China, including the pentavalent RotaTeq (RV5) and the monovalent RV vaccine (RV1). This study aimed to evaluate the cost-effectiveness of RV1 and RV5 to inform the prioritization of provincial immunization program. A decision tree-Markov model was applied to assess the cost-effectiveness of RV1 or RV5 vaccination, compared to no RV vaccination in a 5-year period. The incremental health cost per disability-adjusted life year (DALY) is averted when each kind of RV vaccine included in the immunization program was estimated. It was also compared to the willingness-to-pay (WTP) threshold of 1 time of the Gross Domestic Product (GDP) per capita of Zhejiang province in 2021 (16865.70US$). The uncertainties of these results were assessed through the one-way sensitivity analysis and probabilistic sensitivity analysis. In the base-case scenario, RV5 was the least costly RV vaccine with a cost-effectiveness ratio of 510 US$ per DALY averted. The other RV1 vaccines provided equivalent benefits but at higher costs, with a cost-effectiveness ratio of 4600 US$ per DALY averted. Compared to no vaccination, the probabilities of being cost-effective were 72.3% for RV1 and 88.4% for RV5, at a WTP threshold of 1 time of the GDP per capita. An RV vaccination program using any of the two China-licensed RV vaccines compared to no vaccination would avert 30-70% of outpatient visits, hospitalizations, and deaths from RVGE. RV5 was currently estimated to be the most cost-effective.
Keywords: Rotavirus; cost-effectiveness; immunization program; model; vaccine.