Ghana introduced rotavirus vaccine (ROTARIX 1-dose presentation) into the routine national immunization program in 2012 and switched to the ROTAVAC 5-dose presentation in 2020. A study published recently in PLOS Global Public Health estimated the supply chain and service delivery costs associated with each product (evaluating both the 5-dose and 10-dose presentations), the costs involved in switching products, and compares the cost-effectiveness of both products over the next ten years.
Researchers from the University of Ghana, Ghana Health Service and PATH estimated the supply chain and service delivery costs associated with ROTARIX and ROTAVAC using primary data collected from health facilities in six of the 16 regions in the country. The costs of switching from ROTARIX to ROTAVAC were estimated using information collected from key informant interviews and financial records provided by the government. The UNIVAC decision-support model was used to evaluate the cost-effectiveness (US$ per disability-adjusted life-year (DALY) averted from government and societal perspectives) of ROTARIX and ROTAVAC (5-dose or 10-dose presentations) compared to no vaccination, and to each other, over a ten-year period from 2020 to 2029.
The supply chain and service delivery economic cost per dose was US$2.40 for ROTARIX, $1.81 for ROTAVAC 5-dose, and $1.76 for ROTAVAC 10-dose.
The financial and economic costs of switching from ROTARIX to ROTAVAC 5-dose were $453,070 and $883,626, respectively.
Compared to no vaccination, the cost per DALY averted was $360 for ROTARIX, $298 for ROTAVAC 5-dose, and $273 for ROTAVAC 10-dose.
ROTAVAC 10-dose was the most cost-effective option and would be cost-effective at willingness-to-pay thresholds exceeding 0.12 times the national GDP per capita ($2,206 in the year 2020).
The switch from ROTARIX to ROTAVAC 5-dose in 2020 was cost-saving. Rotavirus vaccination is highly cost-effective in Ghana. The study concluded that a switch from ROTAVAC 5-dose to ROTAVAC 10-dose would be cost-saving and should be considered.
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