Patrícia Coelho de Soárez

Cost-effectiveness analysis of routine rotavirus vaccination in Brazil

OBJECTIVE The objective of this study was to conduct a cost-effectiveness analysis of a universal rotavirus vaccination program among children < or = 5 years of age in Brazil. METHODS Considering a hypothetical annual cohort of approximately 3,300,000 newborns followed over 5 years, a decision-tree model was constructed to examine the possible clinical and economic effects of rotavirus infection with and without routine vaccination of children. Probabilities and unit costs were derived from published research and national administrative data. The impact of different estimates for key parameters was studied using sensitivity analysis. The analysis was conducted from both healthcare system and societal perspectives. RESULTS The vaccination program was estimated to prevent approximately 1,735,351 (54%) of the 3 210 361 cases of rotavirus gastroenteritis and 703 (75%) of 933 rotavirus-associated deaths during the 5-year period. At a vaccine price of 18.6 Brazilian reais (R

Rotavirus morbidity and mortality in children in Brazil

) per dose, this program would cost R

Cost-effectiveness analysis of universal childhood hepatitis A vaccination in Brazil: Regional analyses according to the endemic context

121,673,966 and would save R

Modelling the Force of Infection for Hepatitis A in an Urban Population-Based Survey: A Comparison of Transmission Patterns in Brazilian Macro-Regions

38,536,514 in direct costs to the public healthcare system and R

Cost-Effectiveness Analysis of a Universal Infant Immunization Program with Meningococcal C Conjugate Vaccine in Brazil

71,778,377 in direct and indirect costs to society. The program was estimated to cost R

Cost-effectiveness analysis of introducing universal human papillomavirus vaccination of girls aged 11 years into the National Immunization Program in Brazil.

1,028 and R

Contributions from the systematic review of economic evaluations: the case of childhood hepatitis A vaccination in Brazil

1,713 per life-years saved (LYS) from the societal and healthcare system perspectives, respectively. CONCLUSIONS Universal rotavirus vaccination was a cost-effective strategy for both perspectives. However, these findings are highly sensitive to diarrhea incidence rate, proportion of severe cases, vaccine coverage, and vaccine price.

Cost-Effectiveness Analysis of Universal Vaccination of Adults Aged 60 Years with 23-Valent Pneumococcal Polysaccharide Vaccine versus Current Practice in Brazil

OBJECTIVE To study the epidemiology of rotavirus and estimate rotavirus-associated morbidity and mortality in children<or=5 years of age in Brazil in 2004 before introducing the rotavirus vaccine in Brazils National Immunization Program (Programa Nacional de Imunizações, PNI). METHODS To estimate rotavirus morbidity, published studies (1999-2006) addressing incidence of acute diarrhea among children<or=5 years of age and frequency of rotavirus infection among children with diarrhea in Brazil were reviewed. Diarrhea episodes were divided into three categories of severity by level of care: mild cases requiring only home-based care; moderate cases requiring a visit to an outpatient healthcare facility; and severe cases requiring hospitalization. To estimate rotavirus mortality, information on the number of registered deaths from diarrhea in children<or=5 years of age was obtained from the Mortality Information System (Sistema de Informação sobre Mortalidade, SIM) of Brazils public healthcare system (Sistema Unico de Saúde, SUS) and the proportion of deaths due to rotavirus was calculated. RESULTS Rotavirus infections were estimated to cause 3,525,053 episodes of diarrhea, 655,853 visits to outpatient healthcare facilities, 92,453 hospitalizations, and 850 deaths of children<or=5 years of age each year in Brazil. CONCLUSION Rotavirus infections are an important cause of child morbidity and mortality in Brazil.

Health technology assessment in Brazil: what do healthcare system players think about it?

OBJECTIVE To conduct a cost-effectiveness analysis of a universal childhood hepatitis A vaccination program in Brazil. METHODS An age and time-dependent dynamic model was developed to estimate the incidence of hepatitis A for 24 years. The analysis was run separately according to the pattern of regional endemicity, one for South+Southeast (low endemicity) and one for the North+Northeast+Midwest (intermediate endemicity). The decision analysis model compared universal childhood vaccination with current program of vaccinating high risk individuals. Epidemiologic and cost estimates were based on data from a nationwide seroprevalence survey of viral hepatitis, primary data collection, National Health Information Systems and literature. The analysis was conducted from both the health system and societal perspectives. Costs are expressed in 2008 Brazilian currency (Real). RESULTS A universal immunization program would have a significant impact on disease epidemiology in all regions, resulting in 64% reduction in the number of cases of icteric hepatitis, 59% reduction in deaths for the disease and a 62% decrease of life years lost, in a national perspective. With a vaccine price of R

Methods and challenges for the health impact assessment of vaccination programs in Latin America

16.89 (US