Rotavirus vaccination: a praisable intervention but... does it enable the National Health System to save money?

Key words: Vaccine, Rotavirus, Diarrhoea, Cost

The present “budget impact” study assessed the family and health system costs due to diarrhoea in children < 2 years old, before/after the introduction of a rotavirus vaccine in Brazil in 2006. This kind of evaluations plays a crucial role in the assessment of a health intervention and may help reimbursement decision. This is important especially in Countries with low children’s diarrhoea mortality and high morbidity. In these settings the vaccine is mainly introduced to contain the health and economic burden more than to reduce deaths. The study was made possible by an international collaboration involving the University of Pisa (Italy), the Liverpool School of Tropical Medicine (UK) and the Federal University of Sergipe (Brazil). Information on diarrhoea health care costs and morbidity was obtained from the primary health care system, the National Public Health database (2004-2008) and care-givers. Diarrhoea ambulatory consultations and hospitalisations had a declining trend during the entire period, with additional steeper reductions after vaccine introduction. Therefore, the vaccine was associated with reduced diarrhoea consultations and hospitalization costs and families’ out-of-pocket expenses. Despite these gains, the overall health system costs have increased.