Josephine van Dongen

3 Updated cost-effectiveness and risk-benefit analysis 61 Parameter Total popu- lation Non-tar- get group Target group Distribution Data source Method Vaccination costs Vaccine costs/infants €75 €135.32 Fixed Free market price for targeted vaccina- tion 29 ; for universal vaccination based on assumption as in 11, 31 Application and adminis- tration costs €12.36 €12.36 Fixed 30 Star t-up cost first year €233,760 Fixed 17 LOS length of hospital stay, LE life expectancy, RIVAR Risk-Group InfantVaccination Against Rotavirus, LMR Netherlands National Medical Registry a Of which 80% is aged 5–9 years and 20% is aged 10–14 years b Note, we did not consider any patient and family costs for IS cases c Repor ted vaccine costs exclude costs for spillage; 2% spillage costs was added in the model d Based on population statistics for the year 2014 54 , the most recent year available, we calculated similarly as in Mangen et al. 38 the average working hours/week for a primary caregiver. For this we assumed that, except for single-father households, the female is the primary caregiver taking care of a sick child. In 2014 73.4% of primary caregivers had paid employment, for an average of 22.3 h/week. For an average primary caregiver in the Netherlands this corresponds to 16.4 h/week. Rotavirus hospitalizations A similar approach was used to scale the annual number of community-acquired and nosocomial rotavirus hospitalizations from the RoHo study (2006–2010) to the average for the years 2013–2016.To calculate the scaling factor, we used virological surveillance data on annual rotavirus detections and annual AGE hospitalization data derived from inpatient primary and secondary discharge diagnoses collected by the Dutch National Medical Registry (LMR, national coverage around 90%).The anonymized discharge diagnoses were coded according to the 9th International Classification of Diseases (ICD-9) from 2001 up to 2012 and according to ICD-10 from 2013 onwards. Using an indirect method 15 , the propor tion of AGE-coded hospitalizations attributable to rotavirus (including community-acquired and nosocomial infections) was calculated for each year in children younger than 5 years. A scaling factor was then calculated from the indirectly estimated annual rotavirus hospitalizations comparing the mean of 2006– 2010 (RoHo-study years) to the mean of 2013–2016. This scaling factor was applied to the mean annual number of rotavirus hospitalizations used in the original model ( Table 1 ).