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Table 1 Parameters for model input

From: Targeted rotavirus vaccination of high-risk infants; a low cost and highly cost-effective alternative to universal vaccination

Parameter

Value (95% CI)

Distribution

Data source

Method

 

Total population

Ineligible population

Eligible population

   

Birth cohort (%)

182,662

168,215 (92.1%)

14,448 (7.9%)

-

Statistics Netherlands [46], Dutch Perinatal Registry [38], Eurocat [37]

Published results on birth cohort size and prevalence of high risk conditions

RV incidence

      

<1 year

18,075 (11,768; 22,932)

Calculated

Calculated

Pert

Community-based cohort study [47]

Incidence based on simulations from original study data updated to 2011 population size, see Mangen et al. for details [45] Distribution among eligible and ineligible based on relative size of each group in birth cohort

1 to 4 years

42,218 (24,711; 56,272)

     

5 to 64 years

147,997 (41,573;282,866)

     

5 to 9 years

6.2% of 5 to 64 years

    

Based on age-distribution of cases 5 to 64 years in original study data

10 to 14 years

2.9% of 5–64 years

    

GP visits 0 to 1 years

21.2% (12.8; 26.5)

Calculated

Calculated

Pert

GP based cohort study [48]

Percentage of all RV cases, based on simulations from original GP study data, see Mangen et al. for details [45]. Distribution among eligible and ineligible based on relative size of each group in birth cohort

GP visits 1 to 4 years

18.7% (16.4; 19.9)

     

GP visits 5 to 14 years

4.0% (1.8; 4.7)

     

Hospitalization (95% CI)

Calculated

3,884 (3,244; 4,524)

491 (357; 626)

Pert

RoHo-study

Weighted incidence estimation based on original study data, see Bruijning-Verhagen et al. for details [33].

Nosocomial (95% CI)

Calculated

227 (162; 293)

269 (172; 365)

Pert

RoHo-study

Weighted incidence estimation based on original study data, see Bruijning-Verhagen et al. for details [33]

Mortality rate (per 1,000 RV hospitalizations)

Calculated

0.00 (0.00; 0.04)

0 81 (0.36; 1.46)

Triangular

RoHo study, External dataset Sophia Children’s hospital

Observed mortality cases from both sources were combined for weighted mortality rate estimation

Age distribution of RV hospitalizations and fatal cases

Additional file 1: Table S2

 

RoHo study

 

Utilities RV gastroenteritis

QALY Loss

   

Mild (RV episode without medical care)

0.0011/0.002a

 

GP study in Canada [49], Previous CEA [9]

Published data

Moderate (GP visit)

0.0022/0.004a

   

Severe (Hospitalization)

0.0022/0.004a

   

Nosocomial

Calculated

Calculated

Calculated

 

RoHo Study

Based on severity distribution of nosocomial cases observed in RoHo-study

Mortality

Calculated

80.7 minus patient’s age

Simulated, whereby assuming a life expectancy of 1; 20; 41.3 minus patient’s age with probability of 1/3 eachb

Uniform

Statistics Netherlands [46], Expert opinion

For ineligible: Based on average life expectancy in the Netherlands. For eligible: Based on expert panel†

Direct healthcare costs (Euro)

      

Gastroenteritis episodes without medical care

0

Fixed

  

Standard GP visits

29

 

Guidelines for health-economic evaluations [39]

Standard Cost Prices. See Mangen et al. for details [45]

 Home visit GP

45

   

 GP consultation by phone

15

   

 Prescriptions

40

 

Community-based cohort study and GP based cohort study [49, 50]

See Mangen et al. [45]

Laboratory costs

73

   

Hospitalization

Calculated

2,179 (2,027;2,330)

2,550 (2,508; 3,606)

Pert

RoHo study

Weighted estimates from original study data, see Additional file 1

Nosocomial

Calculated

1,995 (1,242; 2,748)

2,129 (1,203; 3,055)

   

Direct non-healthcare costs

      

RV episode without medical care

Additional diapers

Uniform

Assumption

See Mangen et al. [45]

GP visits

Additional diapers and travel costs

 

Guidelines for health-economic evaluations [39]

 

Hospitalization

Travel costs

Pert

  

Nosocomial

      

Indirect non-healthcare costs c

    

Costs per hour work loss (euro)

31.11

Fixed

Statistics Netherlands [48] Guidelines for health-economic evaluations [39]

See Mangen et al. [45]

Hours of work loss for RV episode without medical care

0.93; 1.36; 0.84 for ages 0 to 4; 5 to 9 and 10 to 14 years respectively

Uniform

Community-based cohort study and GP based cohort study [49, 50]

Dependent of patient-age. See Mangen et al. [45]

Hours of work loss GP visits

1.35; 1.98; 1.23 for ages 0 to 4; 5 to 9 and 10 to 14 years respectively

Uniform

  

Hours of work loss Hospitalization

37.32

 

hospital based observational study [51]

Based on the findings from Friesema et al. [52] for children up to 18, Further details see Mangen et al. [45]

Hours of work loss Nosocomial

24.58

  

Based on the findings from Friesema et al. [52] for children up to 18, adjusted for excess duration of hospitalization among nosocomial in RoHo study (2.7 versus 2.9 days)

Vaccine efficacy

Table 2

 

Vaccine trials [53–57]

 

Herd-immunity

Universal RV vaccination

Targeted RV vaccination

   
 

30% (0% to 46%)

-

 

Triangular

Observational studies from US [58, 59], Australia [60, 61], Belgium [62]

Published data

Vaccination costs

      

 RV1

60; 75; 90

80; 100; 120

 

Previous CEA [10] For Eligible: Assumption

Assumed tender Price

 RV5

60; 75; 90

80; 100; 120

   

 Startup costs first year

218,440

-

    

 Application costs

6.44

  

See Mangen et al. [45]

 Administration costs

1.64

   
  1. aincludes QALY’s lost by caretakers; ball observed fatal RV cases occurred among patients with severe congenital conditions associated with limited life-expectancy (LE). To generate valid estimates of life years lost (YLL) due to RV for each fatal case, four pediatricians (PB, MF, MvH, NH) were individually asked to provide estimates of LE without RV infection based on the patient’s medical records. Pediatricians were requested to estimate for each individual fatal RV case the probability that LE without RV would have been ≤1 year, 1 to 20, 20 to 40 years or comparable to healthy infants. Independent estimates for all seven observed cases were pooled to generate a distribution of mean YLL per fatal RV case; ccosts of third person taking care of sick child.
  2. GP: general practitioner; QALY: quality-adjusted life years; RV: rotavirus.