Evidence map›Paper›PMID 30639458›Full record

ArticleVaccine2019

Projected impact, cost-effectiveness, and budget implications of rotavirus vaccination in Mongolia.

Munkh-Erdene Lusvan, Frédéric Debellut, Andrew Clark, Sodbayar Demberelsuren, Dashpagam Otgonbayar, Tselkhaasuren Batjargal, Sugarmaa Purevsuren, Devin Groman, Jacqueline Tate, Clint Pecenka

Open access · hybridAbstract readEvaluation Study
In one paragraph

Article in Vaccine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 4 countries.

Munkh-Erdene LusvanSchool of Public Health, Mongolian National University of Medical Science, Rm. 334, Sukhbaatar District, S. Zorig Street, Ulaanbaatar, Mongolia.
Frédéric DebellutPATH, Rue de Varembé 7, 1202 Geneva, Switzerland. Electronic address: fdebellut@path.org.
Andrew ClarkLondon School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
Sodbayar DemberelsurenWorld Health Organization Representative Office Mongolia, Government Building VIII, Olympic Street 2, Sukhbaatar District, Ulaanbaatar 14210, Mongolia.
Dashpagam OtgonbayarNational Center for Communicable Disease, Ministry of Health, Government Building VIII, Olympic Street 2, Sukhbaatar District, Ulaanbaatar 14210, Mongolia.
Tselkhaasuren BatjargalNational Center for Communicable Disease, Ministry of Health, Government Building VIII, Olympic Street 2, Sukhbaatar District, Ulaanbaatar 14210, Mongolia.
Sugarmaa PurevsurenSchool of Public Health, Mongolian National University of Medical Science, Rm. 334, Sukhbaatar District, S. Zorig Street, Ulaanbaatar, Mongolia.
Devin GromanPATH, 2201 Westlake Ave, Suite 200, Seattle, WA 98121, USA.
Jacqueline TateCenters for Disease Control and Prevention, Atlanta, GA, USA.
Clint PecenkaPATH, 2201 Westlake Ave, Suite 200, Seattle, WA 98121, USA.
Mongolian National University · MNNational Center for Communicable Diseases · MNProgram for Appropriate Technology in Health · USCenters for Disease Control and Prevention · USMedicines Patent Pool · CHUniversity of London · GB

Funding

World Health Organization 001
6 · The paper itself

Abstract

introductionRotavirus disease in Mongolia is estimated to cause more than 50 deaths yearly and many more cases and hospitalizations. Mongolia must self-finance new vaccines and does not automatically access Gavi prices for vaccines. Given the country's limited resources for health, it is critical to assess potential new vaccine programs. This evaluation estimates the impact, cost-effectiveness, and budget implications associated with a nationwide rotavirus vaccine introduction targeting infants as part of the national immunization program in Mongolia, in order to inform decision-making around introduction.

methodsThe analysis examines the use of the two-dose vaccine ROTARIX®, and three-dose vaccines ROTAVAC® and RotaTeq® compared to no vaccination from the government and the societal perspective. We use a modelling approach informed by local data and published literature to analyze the impact and cost-effectiveness of rotavirus vaccination over a ten-year time period starting in 2019, using a 3% discount rate. Our main outcome measure is the incremental cost-effectiveness ratio (ICER) expressed as US dollar per DALY averted. We assessed uncertainty around a series of parameters through univariate sensitivity analysis.

resultsRotavirus vaccination in Mongolia could avert more than 95,000 rotavirus cases and 271 deaths, over 10 years. Averted visits and hospitalizations represent US$2.4 million in health care costs saved by the government. The vaccination program cost ranges from $6 to $11 million depending on vaccine choice. From the governmental perspective, ICER ranged from $412 to $1050 and from $77 to $715 when considering the societal perspective. Sensitivity analysis highlights vaccine price as the main driver of uncertainty.

conclusionIntroduction of rotavirus vaccination is likely to be highly cost-effective in Mongolia, with ICERs estimated at only a fraction of Mongolia's per capita GDP. From an economic standpoint, ROTAVAC® is the least costly and most cost-effective product choice.

Indexed as

BudgetsCost-Benefit AnalysisCost of IllnessDecision Support TechniquesHealth Care CostsHealth PolicyHumansImmunization ProgramsInfantMongoliaRotavirus InfectionsRotavirus VaccinesVaccinationVaccines, AttenuatedRIX4414 vaccineRotaTeqRotavirus VaccinesVaccines, AttenuatedCost-effectivenessDALYICERMongoliaRotavirusVaccination

Identifiers

PMID30639458
PMCPMC6357530
OpenAlexW2910463736

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.