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Volume 50, Number 5, October 2017

Cost-effectiveness of rotavirus vaccination in Turkey 

Tulin Koksal, Ahmet Zulfikar Akelma, Ali Osman Koksal, Irem Kutukoglu, Osman Ozdemir, Cigdem Nuket Yuksel, Davut Bozkaya, Ferhat Catal, Sinan Sari


Corresponding author:

Osman Ozdemir, Corresponding author. Pinarbasi District, Sanatoryum Street, Ardahan Road, No: 25, Department of Pediatrics, Kecioren Training and Research Hospital, Ankara, Turkey. 


Background and purpose: 

Cost-effectiveness studies about rotavirus (RV) vaccination programs were performed in many countries due to the severe economic burden of RV infections. This study is an economic evaluation performed to assess the potential for introducing the RV vaccine to the Turkish National Immunization Program.



In this retrospective clinical study, the records and laboratory findings of a total of 4126 patients admitted to Turgut Ozal University Hospital, Ankara, Turkey with acute gastroenteritis were analyzed. A model described by Parashar et al. was used to obtain the annual episodes of diarrhea, hospitalization and outpatients visits in Turkey. Monovalent and pentavalent vaccination was assumed to protect in average 85% of RV acute gastroenteritis. All costs are expressed in 2012 United States (US) $, where US$1 equals 1.8 Turkish Liras (TL). Losses of labor costs were not taken into consideration. 



The vaccination program with 85% coverage was cost effective and cost saving compared to no vaccination. A projected birth cohort of 1.25 million children was followed until 5 years of age; a routine vaccination could potentially avert 210,994 cases of diarrhea treated in outpatient hospital facilities and 42,715 hospitalizations. The RV associated economic burden was obtained as US$17,909 million per year (US$14.33 per birth annually) in medical direct costs by using the national level of RV diarrhea disease burden estimates. For monovalent and pentavalent vaccination, assuming a cost of US$31.5 and US$38 per vaccine course, the cost of the vaccination program was estimated to be approximately US$37,878 million and US$45,475 million, respectively. 



At a cost per vaccine course of US$31.5 for monovalent and US$38 for pentavalent vaccine, routine RV vaccination could be potentially cost effective and also cost saving in Turkey. National RV vaccinations will play a significant role in preventing RV infections. 


Key words:

cost effectiveness, gastroenteritis, hospitalized child, rotavirus, vaccination