Cost-Effectiveness of Rotavirus Vaccination in Bolivia From the State Perspective

ASU Author/Contributor (non-ASU co-authors, if there are any, appear on document)
Richard Rheingans Ph.D., Department Chair (Creator)
Appalachian State University (ASU )
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Abstract: Background: In Bolivia, in 2008, the under-five mortality rate is 54 per 1000 live births. Diarrhea causes 15% of these deaths, and 40% of pediatric diarrhea-related hospitalizations are caused by rotavirus illness (RI). Rotavirus vaccination (RV), subsidized by international donors, is expected to reduce morbidity, mortality, and economic burden to the Bolivian state. Estimates of illness and economic burden of RI and their reduction by RV are essential to the Bolivian state’s policies on RV program financing. The goal of this report is to estimate the economic burden of RI and the cost-effectiveness of the RV program. Methods: To assess treatment costs incurred by the healthcare system, we abstracted medical recordsfrom 287 inpatients and 6751 outpatients with acute diarrhea between 2005 and 2006 at 5 sentinel hospitals in 4 geographic regions. RI prevalence rates were estimated from 4 years of national hospital surveillance. We used a decision-analytic model to assess the potential cost-effectiveness of universal RV in Bolivia. Results: Our model estimates that, in a 5-year birth cohort, Bolivia will incur over US$3 million in direct medical costs due to RI. RV reduces, by at least 60%, outpatient visits, hospitalizations, deaths, and total direct medical costs associated with rotavirus diarrhea. Further, RV was cost-savings below a priceof US$3.81 per dose and cost-effective below a price of US$194.10 per dose. Diarrheal mortality and hospitalization inputs were the most important drivers of rotavirus vaccine cost-effectiveness. Discussion: Our data will guide Bolivia’s funding allocation for RV as international subsidies change.

Additional Information

Richard Rheingans, Emily Smith, Emily E. Rowlinson, Volga Iniguez, Kizee A. Etienne, Rosario Rivera, Nataniel Mamani, Maritza Patzi, Percy Halkyer, Juan S. Leon (2011) "Cost-effectiveness of rotavirus vaccination in Bolivia from the state perspective" Vaccine pp.6704-6711 Version of Record Available from
Language: English
Date: 2011
Costs and cost analysis, Diarrhea, Gastroenteritis, Morbidity, Mortality, Rotavirus

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